Noguchi M, Kinami S, Kinoshita K, Kitagawa H, Thomas M, Miyazaki I, Michigishi T, Mizukami Y
Department of Surgery II, Kanazawa University Hospital, School of Medicine, Kanazawa University, Japan.
J Surg Oncol. 1993 Mar;52(3):155-9. doi: 10.1002/jso.2930520307.
We evaluated the risk of bilateral or contralateral cervical lymph node metastases in 135 patients with papillary thyroid cancer who underwent bilateral neck dissection. We confirmed that bilateral jugular lymph node metastases were frequent in patients with obvious carcinoma in both lobes of the gland, in those with cancers arising in the isthmus, in those with clinically detectable bilateral lymphadenopathy, and in those with recurrent thyroid cancer. However, only 24% of the patients who had cancer clinically confined to one lobe with no bilateral or contralateral lymphadenopathy had histologically detected bilateral or contralateral jugular lymph node metastases. But the occurrence of contralateral jugular lymph node metastases was significantly correlated with both clinical lymphadenopathy in the ipsilateral neck and contralateral paratracheal lymph node metastases. Bilateral lymph dissection might be beneficial for these patients.
我们评估了135例行双侧颈清扫术的甲状腺乳头状癌患者发生双侧或对侧颈部淋巴结转移的风险。我们证实，双侧甲状腺叶均有明显癌灶的患者、峡部发生癌灶的患者、临床上可检测到双侧淋巴结病的患者以及复发性甲状腺癌患者中，双侧颈静脉淋巴结转移很常见。然而，临床上癌灶仅局限于一侧叶且无双侧或对侧淋巴结病的患者中，只有24%在组织学上检测到双侧或对侧颈静脉淋巴结转移。但对侧颈静脉淋巴结转移的发生与同侧颈部临床淋巴结病及对侧气管旁淋巴结转移均显著相关。双侧淋巴结清扫术可能对这些患者有益。
