Zhang De-Guang, Gao Li, Miao Yu-Wen, He Gao-Fei, Xie Lei
Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Zhejiang, People's Republic of China. E-mail.
Saudi Med J. 2014 Aug;35(8):832-7.
To identify the risk factors for posterior right recurrent laryngeal nerve lymph node metastasis (PRRLN-LNM) in papillary thyroid carcinoma (PTC).
We conducted a retrospective study of 389 patients with primary PTC who underwent right lobectomy or total thyroidectomy, and comprehensive right or bilateral central compartment dissection (CCD) with or without lateral neck dissection (LND) between January 2010 and May 2013 at the Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Zhejiang, China. The clinicopathological findings were investigated, and relative risk factors for PRRLN-LNM were analyzed.
Central compartment LNM were present in 50.9% (198/389), and PRRLN-LNM were present in 12.6% (49/389) of patients, wherein 3.1% (12/389) had PRRLN-LNM only. A multivariate analysis revealed that younger age (≤ 35 years), extrathyroidal extension (ETE), lateral compartment LNM, prelaryngeal LNM, pretracheal, and right paratracheal LNM were independent predictors of PRRLN-LNM.
This study revealed that younger age (≤ 35 years), ETE, prelaryngeal LNM, lateral compartment LNM, and pretracheal and right paratracheal lymph nodes (anterior to the right recurrent laryngeal nerve [level VIa]), LNM were independent factors of PRRLN-LN (level VIb). Therefore, comprehensive right CCD should be routinely performed for such patients.
确定甲状腺乳头状癌（PTC）患者右侧喉返神经后群淋巴结转移（PRRLN-LNM）的危险因素。
我们对2010年1月至2013年5月在浙江大学微创外科研究所头颈外科接受右侧叶切除术或全甲状腺切除术以及进行了有或没有侧颈清扫术（LND）的全右侧或双侧中央区清扫术（CCD）的389例原发性PTC患者进行了一项回顾性研究。调查临床病理结果，并分析PRRLN-LNM的相关危险因素。
50.9%（198/389）的患者存在中央区淋巴结转移，12.6%（49/389）的患者存在PRRLN-LNM，其中3.1%（12/389）仅存在PRRLN-LNM。多因素分析显示，年龄较小（≤35岁）、甲状腺外侵犯（ETE）、侧区淋巴结转移、喉前淋巴结转移、气管前和右侧气管旁淋巴结转移是PRRLN-LNM的独立预测因素。
本研究表明，年龄较小（≤35岁）、ETE、喉前淋巴结转移、侧区淋巴结转移以及气管前和右侧气管旁淋巴结（右侧喉返神经前方[Ⅵa区]）转移是PRRLN-LN（Ⅵb区）的独立因素。因此，对于此类患者应常规进行全右侧CCD。
