Department of Surgery, College of Medicine, The Catholic University of Korea, Yeouido St, Mary's Hospital, Yeouido-dong, Youngdeungpo-gu, Seoul, Korea.
World J Surg Oncol. 2012 Aug 16;10:164. doi: 10.1186/1477-7819-10-164.
Central and lateral lymph node metastases are quite common in patients with papillary thyroid carcinoma, and the predictors for those metastases have been well studied. Right upper paraesophageal lymph node metastasis has rarely been studied. The aim of this study was to identify the clinicopathological characteristics that may be risk factors for right upper paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma.
This was a prospective observational study of 243 patients with papillary thyroid carcinoma (PTC) who underwent total thyroidectomy and comprehensive central lymph node dissection with or without lateral lymph node dissection between April 2008 and January 2010. The clinicopathologic findings from these patients were investigated and the patterns of lymph node metastasis were analyzed in the patients who had right upper paraesophageal lymph node disease.
Of the 243 patients undergoing lymph node dissection, 14 had right upper paraesophageal lymph node metastases. Two of these patients had right upper paraesophageal lymph node metastasis only, without central compartment metastasis. Univariate analysis of clinicopathologic findings showed that right upper paraesophageal lymph node metastasis had significant association with larger primary tumors, multifocal tumors, extrathyroid extension, and lymphatic invasion (p <0.05 for each factor).
Although there were no independent predictors of right upper paraesophageal lymph node metastasis, it can be the only site of metastasis without other compartmental metastasis. Therefore, during surgery for patients with central or lateral lymph node metastases from PTC, it may be helpful to examine the right upper paraesophageal lymph nodes.
中央和侧方淋巴结转移在甲状腺乳头状癌患者中较为常见，其转移的预测因素已得到充分研究。右上部食管旁淋巴结转移很少被研究。本研究旨在确定可能是甲状腺乳头状癌患者右上部食管旁淋巴结转移的危险因素的临床病理特征。
这是一项前瞻性观察性研究，纳入了 2008 年 4 月至 2010 年 1 月期间接受全甲状腺切除术和综合中央淋巴结清扫术（伴或不伴侧方淋巴结清扫术）的 243 例甲状腺乳头状癌（PTC）患者。研究了这些患者的临床病理发现，并分析了有右上部食管旁淋巴结疾病的患者的淋巴结转移模式。
在接受淋巴结清扫术的 243 例患者中，有 14 例出现右上部食管旁淋巴结转移。其中 2 例患者仅出现右上部食管旁淋巴结转移，而无中央隔室转移。对临床病理发现的单因素分析表明，右上部食管旁淋巴结转移与较大的原发肿瘤、多灶性肿瘤、甲状腺外侵犯和淋巴管浸润显著相关（每个因素的 p 值均<0.05）。
尽管右上部食管旁淋巴结转移没有独立的预测因素，但它可能是唯一没有其他隔室转移的转移部位。因此，在对有中央或侧方淋巴结转移的 PTC 患者进行手术时，检查右上部食管旁淋巴结可能会有所帮助。
