Ertas Burak, Kaya Hakan, Kurtulmus Neslihan, Yakupoglu Abdullah, Giray Serdar, Unal Omer Faruk, Duren Mete
Department of Otorhinolaryngology, Acibadem Maslak Hospital, Istanbul, Turkey.
Endocrine. 2015 Feb;48(1):248-53. doi: 10.1007/s12020-014-0287-x. Epub 2014 May 27.
Differentiated thyroid carcinomas are the most common malignancies of endocrine organs. Metastases to cervical lymph nodes occur in 20-50% of cases. Recurrence and survival rates are closely related to the type of surgery performed. High-resolution ultrasonography (USG) is a sensitive imaging method used to detect occult lymph node metastases in patients with thyroid cancer. We evaluated how intraoperative USG affected surgical success. This was a retrospective study comparing two groups of patients with thyroid carcinoma who underwent cervical lymph node dissection. A total of 101 patients (33 males and 68 females) were included. Group 1 included 53 patients who underwent surgery with intraoperative USG guidance. Group 2 included 48 patients who underwent surgery without the use of USG. All patients were followed up (mean 23 months; range 5-44 months) with thyroglobulin measurements and USG evaluations. Group 1 (intraoperative USG) had a residual/recurrent tumor rate of 1.9% (1/53 patients). Group 2 had a residual/recurrent tumor rate of 12.5% (6/48 patients). A statistically significant difference appeared between the residual/recurrent tumor rates in Groups 1 and 2 (p<0.05). In addition to its classical use in diagnosis and follow-up, intraoperative use of high-resolution USG can improve surgical success and may decrease the number of residual/recurrent tumors encountered during follow-up.
分化型甲状腺癌是内分泌器官最常见的恶性肿瘤。20%至50%的病例会出现颈部淋巴结转移。复发率和生存率与所施行的手术类型密切相关。高分辨率超声检查(USG)是一种用于检测甲状腺癌患者隐匿性淋巴结转移的敏感成像方法。我们评估了术中超声检查如何影响手术成功率。这是一项回顾性研究,比较了两组接受颈部淋巴结清扫术的甲状腺癌患者。共纳入101例患者(33例男性和68例女性)。第1组包括53例在术中超声引导下进行手术的患者。第2组包括48例未使用超声进行手术的患者。所有患者均通过甲状腺球蛋白测量和超声评估进行随访(平均23个月;范围5至44个月)。第1组(术中超声检查)的残余/复发肿瘤率为1.9%(53例患者中的1例)。第2组的残余/复发肿瘤率为12.5%(48例患者中的6例)。第1组和第2组的残余/复发肿瘤率之间存在统计学显著差异(p<0.05)。除了在诊断和随访中的传统应用外,术中使用高分辨率超声检查可以提高手术成功率,并可能减少随访期间遇到的残余/复发肿瘤数量。