术中触诊判定甲状腺乳头状癌中央区淋巴结转移的价值
Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer.
作者信息
Kim Wan Wook, Lee Jeeyeon, Jung Jin Hyang, Park Ho Yong, Kim Won Hwa, Kim Hye Jung, Park Ji-Young, Tufano Ralph P
机构信息
Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Radiology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
出版信息
Yeungnam Univ J Med. 2020 Oct;37(4):302-307. doi: 10.12701/yujm.2020.00122. Epub 2020 Apr 22.
BACKGROUND
This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon's palpation in papillary thyroid cancer.
METHODS
This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness.
RESULTS
Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively.
CONCLUSION
Determination of central LN metastasis by a surgeon's palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.
背景
本研究评估了外科医生触诊判断甲状腺乳头状癌中央淋巴结（LN）转移的实用性。
方法
本研究纳入了2014年10月至2015年2月期间接受甲状腺切除术和中央区淋巴结清扫术的127例患者。可疑LN的标准为硬度。
结果
根据外科医生判断，127例中有20.5%（28/127）的LN可疑转移，其中92.8%（26/28）在最终病理检查中被证实为转移。99例无可疑LN的患者中有38例（38.3%）发现有转移LN，其中29例（76.3%）有微转移。外科医生判断LN转移的敏感性、特异性、阳性和阴性预测值分别为40.6%、96.8%、92.9%和61.6%。
结论
由于高特异性和阳性预测值，外科医生触诊判断中央LN转移可能有助于评估LN，特别是在大转移或高危LN疾病中。
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