1Department of Ear, Nose, Throat, and Head and Neck Surgery, Zagreb University Hospital Centre; 2School of Medicine, University of Zagreb.
Acta Clin Croat. 2020 Jun;59(Suppl 1):122-128. doi: 10.20471/acc.2020.59.s1.16.
Cervical lymph node metastases are frequently found in papillary thyroid carcinoma (PTC) and occur in a stepwise fashion. Skip metastases that omit the central compartment and spread initially in lateral neck levels are present in a certain share of patients, and their significance is poorly understood. The aim of this prospective study was to identify their possible predictors and clinicopathological factors in a group of patients with PTC with lateral lymph node (LLN) metastases.
We enrolled 68 patients with PTC with preoperatively evaluated LLN metastases who underwent total thyroidectomy with lateral lymph node dissection between 2011 and 2018. We analysed the clinicopathological features and pattern of dissemination of continuous and skip metastases.
The prevalence of skip metastases was 23.5%. Compared with the continuous metastases group, the patients were older, had primary tumors that were more often situated unilaterally, and had smaller primary tumor size. Level II was less often involved, and none of the patients with skip metastases had all LNN positive (p = 0.05).
Skip metastases occur more frequently in older patients and display certain clinicopathological features like smaller size of the primary tumor and dissemination in less lateral neck levels. In the view of the fact that they are found rather frequently, lateral neck regions should be meticulously investigated in patients with PTC without central lymph node (CLL) metastases.
甲状腺乳头状癌（PTC）常发生颈部淋巴结转移，且呈阶段性转移。某些患者存在跳过中央区而首先向侧颈部转移的跳跃式转移，其意义尚未完全明确。本前瞻性研究旨在分析一组伴有侧颈部淋巴结（LLN）转移的 PTC 患者中，跳跃式转移的可能预测因子和临床病理因素。
我们纳入了 2011 年至 2018 年间行全甲状腺切除术和侧颈部淋巴结清扫术的 68 例术前评估有 LLN 转移的 PTC 患者。我们分析了连续转移和跳跃转移的临床病理特征和播散模式。
跳跃式转移的发生率为 23.5%。与连续转移组相比，跳跃转移组患者年龄更大，肿瘤多位于单侧，肿瘤体积更小。II 区受累较少，且跳跃转移组无一例所有侧颈部淋巴结均阳性（p=0.05）。
跳跃式转移更常见于老年患者，且具有一些临床病理特征，如原发肿瘤较小，向较少的侧颈部转移。鉴于跳跃式转移较为常见，对于无中央区淋巴结（CLL）转移的 PTC 患者，应仔细检查侧颈部区域。
