基于甲状腺乳头状癌原发灶位置预测颈部淋巴结转移模式。
Possible prediction of patterns of cervical lymph node spread based on primary tumor location in papillary thyroid carcinomas.
出版信息
Turk J Med Sci. 2019 Feb 11;49(1):217-221. doi: 10.3906/sag-1807-79.
BACKROUND/AIM: Papillary thyroid carcinomas (PTC) frequently metastasize to regional lymph nodes. Our purpose was to investigate the predictive role of tumor location for lymph node metastasis pattern in PTCs.
MATERIALS AND METHODS
Medical records of 110 PTC patients were reviewed retrospectively. Tumor location was determined as upper, middle, and lower pole according to ultrasonography (USG) findings. The effects of age, sex, tumor size, and location on lymph node metastasis were investigated.
RESULTS
The series comprised 87% females (n = 96) and 13% males (n = 14). Forty-three patients had central neck metastasis (CNM) and 14 had lateral neck metastasis (LNM). Upper pole tumors (UPT) metastasized to the central neck (CN) at a lower rate (17.6%) than middle (40.0%) or lower (48.5%) poles overall (P = 0.104), while it was at a significantly lower rate (13.3%) in the PTC group (P < 0.05). UPTs (n = 17) metastasized to the lateral neck (LN) almost 2-fold more. It was observed that 3 of 4 UPTs spread directly to the LN without CNM.
CONCLUSION
In our opinion, UPTs have propensity to demonstrate metastasis to LN rather than the CN in PTCs. Therefore, UPTs should be evaluated meticulously in terms of LNM. New studies could suggest that CN dissection is not performed for low-risk PTCs in UPTs.
背景/目的：甲状腺乳头状癌（PTC）常发生颈部淋巴结转移。我们的目的是探讨肿瘤位置对 PTC 淋巴结转移模式的预测作用。
材料和方法
回顾性分析 110 例 PTC 患者的病历。根据超声（USG）结果，肿瘤位置确定为上、中、下极。研究年龄、性别、肿瘤大小和位置对淋巴结转移的影响。
结果
该系列包括 87%的女性（n=96）和 13%的男性（n=14）。43 例患者有中央颈部转移（CNM），14 例有侧颈部转移（LNM）。上极肿瘤（UPT）向中央颈部（CN）转移的比例（17.6%）低于中极（40.0%）或下极（48.5%）（P=0.104），而在 PTC 组中，这一比例明显较低（13.3%）（P<0.05）。17 例 UPT 向侧颈部（LN）转移的比例几乎增加了两倍。观察到 4 例 UPT 中有 3 例直接向 LN 转移而无 CNM。
结论
在我们看来，在 PTC 中，上极肿瘤更倾向于向 LN 转移而不是 CN。因此，应仔细评估 UPT 的 LNM。新的研究可能表明，在 UPT 中，低危 PTC 不需要进行 CN 清扫。
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