Xia B Y, Abuduwaili Munire, Fei Y, Xing Z C, Liu Y, Zhang L Y, Su A P, Zhu J Q
Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Wai Ke Za Zhi. 2021 Jun 1;59(6):502-506. doi: 10.3760/cma.j.cn112139-20200706-00541.
To examine the correlation factors of contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma with lateral cervical lymph node metastasis. The clinical data of patients with unilateral papillary thyroid carcinoma who underwent total thyroidectomy and bilateral central lymph node dissection and ipsilateral cervical lymph node dissection from June 2016 to June 2018 at Department of Thyroid Surgery, West China Hospital, Sichuan University were analyzed retrospectively. A total of 317 patients, including 87 males and 230 females, aged (41.4±12.1) years (range: 16 to 75 years), were enrolled in this study. The risk factors of contralateral central lymph node metastasis were analyzed by χ test and Spearman correlation analysis. There were 116, 69, 269, and 181 cases of pretracheal lymph node, prelaryngeal lymph node, ipsilateral central lymph node and contralateral central lymph node metastasis, respectively, and 16 cases of skipping metastasis. Univariate analysis showed that contralateral central lymph node metastasis was associated with gender, maximum tumor diameter, capsule invasion, pretracheal lymph node metastasis, prelaryngeal lymph node metastasis, and ipsilateral central lymph node metastasis (all <0.05). Spearman correlation analysis showed that male (=0.162, =0.004), maximum tumor diameter>10 mm (=0.184, =0.001), capsule invasion (=0.135, =0.016), pretracheal lymph node metastasis (=0.394, <0.01), prelaryngeal lymph node metastasis (=0.272, <0.01) and ipsilateral central lymph node metastasis (=0.203, <0.01) were independent correlation factors for contralateral central lymph node metastasis. For patients with unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis, bilateral central lymph node dissection should be considered if male, tumor diameter>10 mm, capsule invasion, pretracheal lymph node metastasis, prelaryngeal lymph node metastasis, or ipsilateral central lymph node metastasis.
探讨单侧甲状腺乳头状癌伴侧颈淋巴结转移时对侧中央淋巴结转移的相关因素。回顾性分析2016年6月至2018年6月在四川大学华西医院甲状腺外科行甲状腺全切除术、双侧中央淋巴结清扫及同侧颈淋巴结清扫的单侧甲状腺乳头状癌患者的临床资料。本研究共纳入317例患者，其中男性87例，女性230例，年龄（41.4±12.1）岁（范围：16至75岁）。采用χ检验和Spearman相关性分析对侧中央淋巴结转移的危险因素。气管前淋巴结转移、喉前淋巴结转移、同侧中央淋巴结转移和对侧中央淋巴结转移分别有116、69、269和181例，跳跃转移16例。单因素分析显示，对侧中央淋巴结转移与性别、最大肿瘤直径、包膜侵犯、气管前淋巴结转移、喉前淋巴结转移及同侧中央淋巴结转移有关（均P<0.05）。Spearman相关性分析显示，男性（r=0.162，P=0.004）、最大肿瘤直径>10mm（r=0.184，P=0.001）、包膜侵犯（r=0.135，P=0.016）、气管前淋巴结转移（r=0.394，P<0.01）、喉前淋巴结转移（r=0.272，P<0.01）及同侧中央淋巴结转移（r=0.203，P<0.01）是对侧中央淋巴结转移的独立相关因素。对于单侧甲状腺乳头状癌伴同侧颈淋巴结转移的患者，若为男性、肿瘤直径>10mm、包膜侵犯、气管前淋巴结转移、喉前淋巴结转移或同侧中央淋巴结转移，应考虑行双侧中央淋巴结清扫。
