Liu Bing, Qin Huadong, Zhang Bin, Shi Tiefeng, Li Chuanle, Liu Yao, Song Meiyue
Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China.
Department of Pathology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China.
Oncol Lett. 2017 Jan;13(1):253-257. doi: 10.3892/ol.2016.5450. Epub 2016 Nov 30.
We compared the clinical effects and prognosis of patients receiving lymph node dissection after surgical removal of the thyroid tissues and those not receiving it after the removal. A total of 80 patients diagnosed with differentiated thyroid carcinoma (DTC) by our hospital from March 2012 to March 2014 were successively included in the study. The cases were divided into the control group (n=36 cases) and observation group (n=44 cases), and the two groups underwent total or subtotal resection of the thyroid. In the control group, patients underwent preoperative high-frequency color ultrasonography, and the most suspicious lymph node was removed. In the observation group, patients underwent preoperative high-frequency color ultrasonography, and the surgeons cleared the lymph node of the widest range. Difference in clinical effects and prognosis of the two groups were compared. After nearly a year's follow-up observation, the tumor recurrence rate of the observation group was significantly lower than that of the control group and the survival rate of the observation group was significantly higher than that of the control group (P<0.05). The rate of surgery complications and comparative difference of the two patient groups had no statistical significance (P>0.05). When comparing the data of lymphatic metastasis tested by preoperative high-frequency color ultrasonography with intraoperative diagnosed figures, sensitivity was 97.4%, specificity 33.3%, positive predictive value 90.2% and the negative predictive value 66.7%. In conclusion, removal of the lymph node for DTC patients having undergone thyroid tissue excision with preoperative high-frequency color ultrasonography can be beneficial to improve the effects along with reduction in the recurrence rate.
我们比较了甲状腺组织手术切除后接受淋巴结清扫患者与未接受淋巴结清扫患者的临床疗效及预后。2012年3月至2014年3月期间我院确诊的80例分化型甲状腺癌(DTC)患者先后纳入本研究。将病例分为对照组(n = 36例)和观察组(n = 44例),两组均行甲状腺全切或次全切除术。对照组患者术前行高频彩色超声检查,切除最可疑的淋巴结。观察组患者术前行高频彩色超声检查,外科医生清扫范围最广的淋巴结。比较两组的临床疗效及预后差异。经过近一年的随访观察,观察组的肿瘤复发率明显低于对照组,观察组的生存率明显高于对照组(P<0.05)。两组患者的手术并发症发生率及比较差异无统计学意义(P>0.05)。术前高频彩色超声检查检测的淋巴转移数据与术中诊断数据比较,灵敏度为97.4%,特异度为33.3%,阳性预测值为90.2%,阴性预测值为66.7%。综上所述,对术前行高频彩色超声检查的DTC患者行甲状腺组织切除术后进行淋巴结清扫,有利于提高疗效并降低复发率。