甲状腺乳头状癌颈部淋巴结转移危险因素及预防性中央区淋巴结清扫可行性的临床分析
Clinical Analysis of Cervical Lymph Node Metastasis Risk Factors and the Feasibility of Prophylactic Central Lymph Node Dissection in Papillary Thyroid Carcinoma.
作者信息
Chen Yifan, Chen Shuo, Lin Xiaoying, Huang Xiangqing, Yu Xiaofang, Chen Juying
机构信息
Department of General Surgery, South Branch of Fujian Provincial Hospital, Fuzhou 350000, Fujian, China.
Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350000, Fujian, China.
出版信息
Int J Endocrinol. 2021 Jan 31;2021:6635686. doi: 10.1155/2021/6635686. eCollection 2021.
Abstract
OBJECTIVE
To identify the risk factors for cervical lymph node metastasis (CLNM) and the feasibility of prophylactic central lymph node dissection.
METHODS
The characteristics of 1107 patients were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with lymph node metastasis. The relationship between the central lymph node dissection (CLND) and lateral lymph node metastasis (LLNM) was analyzed using the correlation analysis.
RESULTS
The probability of CLNM was closely related to the male gender, age <55, and the increase of tumor size. Those patients with an increase in tumor size and CLNM were extremely prone to LLNM. Also, LLNM was more likely to happen in those with the more positive central lymph nodes. Routine prophylactic central lymph node dissection (P-CLND) did not increase the risk of complications.
CONCLUSION
P-CLND should be considered as a reasonable surgical treatment for PTC.
摘要
目的
确定颈淋巴结转移（CLNM）的危险因素以及预防性中央淋巴结清扫的可行性。
方法
提取并分析1107例患者的特征。采用单因素和多因素分析来确定与淋巴结转移相关的危险因素。使用相关性分析来分析中央淋巴结清扫（CLND）与侧方淋巴结转移（LLNM）之间的关系。
结果
CLNM的概率与男性、年龄<55岁以及肿瘤大小增加密切相关。肿瘤大小增加且发生CLNM的患者极易发生LLNM。此外，中央淋巴结阳性越多的患者越容易发生LLNM。常规预防性中央淋巴结清扫（P-CLND）不会增加并发症风险。
结论
P-CLND应被视为甲状腺乳头状癌（PTC）合理的手术治疗方式。
相似文献
1
Clinical Analysis of Cervical Lymph Node Metastasis Risk Factors and the Feasibility of Prophylactic Central Lymph Node Dissection in Papillary Thyroid Carcinoma.
Int J Endocrinol. 2021 Jan 31;2021:6635686. doi: 10.1155/2021/6635686. eCollection 2021.
2
Risk factors of cervical lymph node metastasis in multifocal papillary thyroid cancer.
Front Oncol. 2022 Dec 8;12:1003336. doi: 10.3389/fonc.2022.1003336. eCollection 2022.
3
Clinicopathological features for predicting central and lateral lymph node metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection.
Mol Clin Oncol. 2017 Jan;6(1):49-55. doi: 10.3892/mco.2016.1085. Epub 2016 Nov 18.
4
Predictive factors for central lymph node and lateral cervical lymph node metastases in papillary thyroid carcinoma.
Clin Transl Oncol. 2019 Nov;21(11):1482-1491. doi: 10.1007/s12094-019-02076-0. Epub 2019 Mar 16.
5
A prediction model incorporating the BRAF protein status for determining the risk of cervical lateral lymph node metastasis in papillary thyroid cancer patients with central lymph node metastasis.
Eur J Surg Oncol. 2021 Nov;47(11):2774-2780. doi: 10.1016/j.ejso.2021.08.033. Epub 2021 Aug 27.
6
Optimal range of lymph node dissection in patients with unilateral papillary thyroid carcinoma with lateral cervical lymph node metastasis.
Front Oncol. 2023 Dec 14;13:1307937. doi: 10.3389/fonc.2023.1307937. eCollection 2023.
7
Risk factor analysis for predicting cervical lymph node metastasis in papillary thyroid carcinoma: a study of 966 patients.
BMC Cancer. 2019 Jun 25;19(1):622. doi: 10.1186/s12885-019-5835-6.
8
Analysis of risk factors for lateral lymph node metastasis in papillary thyroid carcinoma: A retrospective cohort study.
World J Otorhinolaryngol Head Neck Surg. 2022 Apr 18;8(3):274-278. doi: 10.1016/j.wjorl.2021.01.002. eCollection 2022 Sep.
9
Prophylactic central lymph node dissection performed selectively with cN0 papillary thyroid carcinoma according to a risk-scoring model.
Gland Surg. 2022 Feb;11(2):378-388. doi: 10.21037/gs-21-906.
10
Clinical analysis of cervical lymph node metastasis patterns and multivariate factors in differentiated thyroid carcinoma.
Oncol Lett. 2023 Aug 22;26(4):431. doi: 10.3892/ol.2023.14018. eCollection 2023 Oct.
引用本文的文献
1
A novel deep learning model based on multimodal contrast-enhanced ultrasound dynamic video for predicting occult lymph node metastasis in papillary thyroid carcinoma.
Front Endocrinol (Lausanne). 2025 Jul 24;16:1634875. doi: 10.3389/fendo.2025.1634875. eCollection 2025.
2
Factors associated with occult lateral lymph node metastases in patients with clinically lymph node negative papillary thyroid carcinoma: a systematic review and meta-analysis.
Front Endocrinol (Lausanne). 2024 Oct 18;15:1353923. doi: 10.3389/fendo.2024.1353923. eCollection 2024.
3
Correlation Between Serum 1,25(OH)2D3, Serum Phosphorus, and Parathyroid Hormone and Parathyroid Function After Central Lymph Node Dissection in Patients with Papillary Thyroid Carcinoma.
Mol Biotechnol. 2025 Apr;67(4):1619-1627. doi: 10.1007/s12033-024-01147-0. Epub 2024 Apr 18.
4
The value of total tumor diameter in unilateral multifocal papillary thyroid carcinoma: a propensity score matching analysis.
Front Endocrinol (Lausanne). 2023 Sep 6;14:1217613. doi: 10.3389/fendo.2023.1217613. eCollection 2023.
5
Analysis of the influence factors of cervical lymph node metastasis in Papillary thyroid carcinoma: A retrospective observational study.
Medicine (Baltimore). 2023 Sep 8;102(36):e35045. doi: 10.1097/MD.0000000000035045.
6
The role of prophylactic central compartment neck dissection in patients with T1-T2 cN0 papillary thyroid carcinoma.
Gland Surg. 2023 Mar 31;12(3):344-353. doi: 10.21037/gs-22-550. Epub 2023 Mar 16.
7
Value of dissection of lymph nodes posterior to the right recurrent laryngeal nerve in patients with cN papillary thyroid carcinoma.
Gland Surg. 2022 Jul;11(7):1204-1211. doi: 10.21037/gs-22-337.
8
Predictors and a Prediction Model for Central Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma (cN0).
Front Endocrinol (Lausanne). 2022 Jan 27;12:789310. doi: 10.3389/fendo.2021.789310. eCollection 2021.
本文引用的文献
1
Risk Factors for Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma: A Single-Center Retrospective Study.
Int J Endocrinol. 2019 Jan 15;2019:8579828. doi: 10.1155/2019/8579828. eCollection 2019.
2
NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018.
J Natl Compr Canc Netw. 2018 Dec;16(12):1429-1440. doi: 10.6004/jnccn.2018.0089.
3
The New TNM Staging System for Thyroid Cancer and the Risk of Disease Downstaging.
Front Endocrinol (Lausanne). 2018 Sep 18;9:541. doi: 10.3389/fendo.2018.00541. eCollection 2018.
4
Clinical analysis of cervical lymph node metastasis risk factors in patients with papillary thyroid microcarcinoma.
J Endocrinol Invest. 2019 Feb;42(2):227-236. doi: 10.1007/s40618-018-0908-y. Epub 2018 Jun 6.
5
Skip metastasis in papillary thyroid carcinoma is difficult to predict in clinical practice.
BMC Cancer. 2017 Oct 25;17(1):702. doi: 10.1186/s12885-017-3698-2.
6
Clinical and pathologic predictors of central lymph node metastasis in papillary thyroid microcarcinoma: a retrospective cohort study.
J Endocrinol Invest. 2018 Apr;41(4):403-409. doi: 10.1007/s40618-017-0759-y. Epub 2017 Sep 7.
7
The thyroid cancer epidemic, 2017 perspective.
Curr Opin Endocrinol Diabetes Obes. 2017 Oct;24(5):332-336. doi: 10.1097/MED.0000000000000359.
8
Latero-cervical lymph node metastases (N1b) represent an additional risk factor for papillary thyroid cancer outcome.
J Endocrinol Invest. 2017 Dec;40(12):1355-1363. doi: 10.1007/s40618-017-0714-y. Epub 2017 Jun 23.
9
Risk factors for lymph node metastasis (LNM) in patients with papillary thyroid microcarcinoma (PTMC): role of preoperative ultrasound.
J Int Med Res. 2017 Jun;45(3):1221-1230. doi: 10.1177/0300060517708943. Epub 2017 May 23.
10
Clinicopathological features for predicting central and lateral lymph node metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection.
Mol Clin Oncol. 2017 Jan;6(1):49-55. doi: 10.3892/mco.2016.1085. Epub 2016 Nov 18.
Zotero 插件