Maksimovic Sinisa, Jakovljevic Branislava, Gojkovic Zdenka
Public Health Institution Hospital "Sveti Vracevi" in Bijeljina, University of Banja Luka, Faculty of Medicine, Bosnia and Herzegovina.
S-TETIK Health Institution, Banja Luka, University of Banja Luka, Faculty of Medicine.
Med Arch. 2018 Apr;72(2):108-111. doi: 10.5455/medarh.2018.72.108-111.
The purpose of this study is to establish whether the lymph node metastases of the papillary thyroid carcinoma are a significant factor in recurrence of the disease by analyzing the time until recurrence of the disease and frequency of recurrence of the disease.
From 1 January 1995 until 30 June 2017, 102 patients were treated at the Public Health Institute Hospital "Sveti Vracevi" in Bijeljina for PTC. In all patients, surgery of the thyroid gland and/or lymph nodes of the neck was performed. Total thyroidectomy (TT) was performed in 20 patients and near-total thyroidectomy leaving <1 g thyroid tissue adjacent to the recurrent laryngeal nerve in 7 patients. TT and lymph nodes dissection were performed in 71 patients. Palliative surgery and biopsy due to locally advanced disease were performed in 3 patients.
In our study, 102 patients with PTC were analyzed. 82 patients experienced pure PTC (80.4%), the other 20 patients (19.6%) experienced other variants of PTC. 24 patients (23.5%) experienced multi centric or bilateral tumors. 71 patients (69.6%) experienced histologically verified metastases in the lymph nodes of the neck. 7 patients (6.8%) experienced distant metastases. 20 patients underwent total thyroidectomy (TT), and 7 near-total thyroidectomy. Total thyroidectomy + dissection of central and lower jugular lymph nodes with frozen section histopathology verification was performed in 71 patients (69.6%). Out of these 71 patients, in 50 patients (70.4%) metastases were verified in the lower jugular lymph nodes. A modified lymph node dissection (MRND) was also performed in these patients.
Lymph node metastases of the papillary thyroid carcinoma are a plausible prognostic factor. They are important for recurrence of the disease, but not for survival.
本研究的目的是通过分析疾病复发时间和疾病复发频率,确定甲状腺乳头状癌的淋巴结转移是否是疾病复发的一个重要因素。
1995年1月1日至2017年6月30日,比耶利纳的“斯韦蒂弗拉切维”公共卫生研究所医院对102例甲状腺乳头状癌患者进行了治疗。所有患者均接受了甲状腺和/或颈部淋巴结手术。20例患者进行了全甲状腺切除术(TT),7例患者进行了近全甲状腺切除术,在喉返神经旁保留<1g甲状腺组织。71例患者进行了TT和淋巴结清扫术。3例患者因局部晚期疾病进行了姑息性手术和活检。
在我们的研究中,对102例甲状腺乳头状癌患者进行了分析。82例患者为单纯甲状腺乳头状癌(80.4%),其他20例患者(19.6%)为甲状腺乳头状癌的其他变体。24例患者(23.5%)患有多中心或双侧肿瘤。71例患者(69.6%)经组织学证实颈部淋巴结转移。7例患者(6.8%)发生远处转移。20例患者接受了全甲状腺切除术(TT),7例接受了近全甲状腺切除术。71例患者(69.6%)进行了全甲状腺切除术+中央和下颈淋巴结清扫术,并进行了冰冻切片组织病理学验证。在这71例患者中,50例患者(70.4%)在下颈淋巴结中证实有转移。这些患者还进行了改良淋巴结清扫术(MRND)。
甲状腺乳头状癌的淋巴结转移是一个合理的预后因素。它们对疾病复发很重要,但对生存不重要。