甲状腺乳头状癌中肿瘤位置依赖性的颈侧区跳跃性淋巴结转移
Tumor location-dependent skip lateral cervical lymph node metastasis in papillary thyroid cancer.
作者信息
Lee Yoon Se, Shin Sung-Chan, Lim Yun-Sung, Lee Jin-Choon, Wang Soo-Geun, Son Seok-Man, Kim In-Ju, Lee Byung-Joo
机构信息
Department of Otorhinolaryngology - Head and Neck Surgery, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea; Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
出版信息
Head Neck. 2014 Jun;36(6):887-91. doi: 10.1002/hed.23391. Epub 2014 Jan 13.
BACKGROUND
Lateral cervical lymph node metastasis without central lymph node (CLN) metastasis is not infrequent in papillary thyroid cancer (PTC). This study was designed to investigate the frequency and pattern of skip metastasis in PTC.
METHODS
We reviewed 131 patients who underwent total thyroidectomy with CLN dissection and selective lymph node dissection. Tumor location was classified in 3 areas (upper, middle, and lower third) based on preoperative ultrasonographic findings.
RESULTS
All skip metastases occurred in patients whose tumors had been on the upper part of the thyroid (p < .001). Among 9 patients with skip metastasis, level III lymph nodes (66.7%) were the lymph nodes that were most frequently involved in skip metastasis.
CONCLUSION
Primary tumors in the upper portion of the thyroid are closely linked to skip metastasis. Careful preoperative evaluation of lateral cervical lymph nodes is suggested when a tumor is in the upper portion.
背景
在甲状腺乳头状癌（PTC）中，侧方颈部淋巴结转移而无中央淋巴结（CLN）转移并不罕见。本研究旨在调查PTC中跳跃转移的频率和模式。
方法
我们回顾了131例行全甲状腺切除术并进行CLN清扫和选择性淋巴结清扫的患者。根据术前超声检查结果，将肿瘤位置分为3个区域（上、中、下三分之一）。
结果
所有跳跃转移均发生在肿瘤位于甲状腺上部的患者中（p＜0.001）。在9例发生跳跃转移的患者中，Ⅲ区淋巴结（66.7%）是最常发生跳跃转移的淋巴结。
结论
甲状腺上部的原发肿瘤与跳跃转移密切相关。当肿瘤位于上部时，建议术前仔细评估侧方颈部淋巴结。
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