Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3, Ashahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Surg Today. 2013 Feb;43(2):178-84. doi: 10.1007/s00595-012-0228-3. Epub 2012 Jun 26.
This study attempted to reveal the pattern of initial lymphatic spread in order to investigate the clinical significances of lymph node metastasis in papillary thyroid carcinoma (PTC) since such information has yet to be elucidated in previous studies.
This study reviewed 501 consecutive patients with PTC who had been surgically treated, accompanied by routine node dissection of the central, and lateral compartments. Thirty-eight cases were found to have only one metastatic node, and 62 cases were found to have 2 or 3 metastatic nodes. The locations of these metastatic nodes were mapped, and evaluated.
The initial lymph node metastasis occurred equally in the lateral and central compartments (19 vs. 19 nodes). Metastatic nodes were more frequently found in the central compartment (60 and 65 %) in cases with 2- and 3-node involvements. Twenty-two (60 %) and 33 (65 %) cases had at least one instance of lateral node involvement in those cases, respectively.
The current results demonstrated the pattern of initial lymphatic spread in PTC cases, and indicated the importance of evaluating the lateral nodes of at least compartments III and IV for accurate pathological staging, as well as for investigating the nature of the disease.
本研究旨在揭示甲状腺乳头状癌（PTC）初始淋巴转移的模式，以探讨淋巴结转移的临床意义，因为之前的研究尚未阐明这方面的信息。
本研究回顾了 501 例接受手术治疗的 PTC 连续患者，常规进行中央和侧区淋巴结清扫。发现 38 例仅有 1 个转移性淋巴结，62 例有 2 或 3 个转移性淋巴结。对这些转移性淋巴结的位置进行了映射和评估。
初始淋巴结转移在侧区和中央区的发生率相等（19 个 vs. 19 个淋巴结）。在 2 个和 3 个淋巴结受累的病例中，中央区的转移淋巴结更为常见（60 和 65%）。在这些病例中，分别有 22（60%）和 33（65%）例至少有一个侧区淋巴结受累。
本研究结果显示了 PTC 病例中初始淋巴扩散的模式，并表明评估至少包括第 III 和第 IV 区的侧区淋巴结对于准确的病理分期以及研究疾病性质非常重要。
