Wang Yongkun, Wu Zhen, Yan Jinqiang, Yao Yumin, Han Lin
Department of Thyroid Surgery, Liaocheng People's Hospital, Affiliated to Shandong First Medical University, Liaocheng, Shandong, China.
Department of Pathology, Liaocheng People's Hospital, Affiliated to Shandong First Medical University, Liaocheng, Shandong, China.
Front Oncol. 2024 Apr 5;14:1280607. doi: 10.3389/fonc.2024.1280607. eCollection 2024.
There is still controversy about whether cervical lymph node dissection should be performed in surgical treatment of PTC. Based on the data of thyroid cancer patients from Liaocheng People's Hospital from 2015 to 2018, this study focused on appropriate indications for cervical lymph node dissection surgery.
The clinical and pathological data of patients with initial treatment of PTC in thyroid surgery department from 2015 to 2018 were collected. In all cases, 1001 patients underwent total thyroidectomy + central lymph node dissection, and 1107 patients underwent total thyroidectomy + central + cervical lymph node dissection.
The average metastasis rate of all cases was 57.23%, and even the metastasis rate of PTMC was as high as 48.97%. The total metastasis rate of central and lateral cervical lymph nodes was 74.44%, and the cervical lymph nodes were present in 49.32% of the metastatic cases. In 55.56% of the cases, the tumor diameter was more than 1 cm, and the metastasis rate of cervical lateral area was 56%. With the increase of tumor diameter, the cervical metastasis rate increased from 22.54% to 73.33%.
The metastasis rate of PTC is more than 50%, and nearly half of them have cervical metastasis, especially in patients with high risk factors. We observed that PTC 1 cm or greater has significant rates of metastasis.
在甲状腺乳头状癌（PTC）的外科治疗中，对于是否应进行颈部淋巴结清扫仍存在争议。基于聊城市人民医院2015年至2018年甲状腺癌患者的数据，本研究聚焦于颈部淋巴结清扫手术的合适指征。
收集2015年至2018年在甲状腺外科初次治疗的PTC患者的临床和病理数据。所有病例中，1001例患者接受了全甲状腺切除术 + 中央区淋巴结清扫，1107例患者接受了全甲状腺切除术 + 中央区 + 颈部淋巴结清扫。
所有病例的平均转移率为57.23%，即使是微小癌（PTMC）的转移率也高达48.97%。中央区和颈部侧方淋巴结的总转移率为74.44%，49.32%的转移病例存在颈部淋巴结转移。55.56%的病例肿瘤直径大于1 cm，颈部侧方区域的转移率为56%。随着肿瘤直径的增加，颈部转移率从22.54%升至73.33%。
PTC的转移率超过50%，其中近一半有颈部转移，尤其是有高危因素的患者。我们观察到直径1 cm及以上的PTC有显著的转移率。
