Clinical analysis of level Ⅱ occult metastasis of papillary thyroid carcinoma
10.3760/cma.j.issn.1673-0860.2011.09.007
- VernacularTitle:甲状腺乳头状癌Ⅱ区淋巴结隐匿性转移的临床分析
- Author:
Liu-Yang ZHANG
1
;
Xuan ZHOU
;
Xiao-Feng YAO
;
Qiang ZHANG
;
Lun ZHANG
Author Information
1. 天津医科大学附属肿瘤医院
- Keywords:
Thyroid neoplasms;
Carcinoma,papillary;
Lymphatic metastasis;
Neck dissection
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2011;46(9):733-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the relavent factors occult Ⅱ lymph node metastases in papillary thyroid carcinoma (PTC) with clinical factors. Methods The medical records of 213 PTC patients with clinically positive neck lymph nodes in level Ⅲ and Ⅳ, and/or Ⅴ based on preoperative ultrasonography,treated between January 2003 and December 2009 were retrospectively reviewed. All patients had no suspicion of clinical positive neck nodes in level Ⅱ. Univariate and Multivariate analysis were performed using the Pearson chi-square test or Fisher's exact test and a binary logistic regression test, respectively.Results The rate of metastasis at levels Ⅲ, Ⅳ, Ⅴ and Ⅵwas83.6％ (178/213),75. 1％(160/213),13. 1％(28/213) and 79.3％ ( 169/213), respectively. The rate of occult metastasis at level Ⅱ were observed in 16. 0％ (34/213). In univariate analysis, lymph node metastasis in level Ⅱ was statistically significantly more frequent in patients with positive level Ⅲ lymph node and positive lymph node throughout the lateral neck ( level Ⅲ + Ⅳ, x2 were 11. 120 and 5. 614 respectively, P ＜ 0. 05 ). Multivariate analysis showed that positive lymph node involvement in all lateral neck ( level Ⅲ + Ⅳ ) was an independent predictive factor of level Ⅱ lymph node metastasis ( P = 0. 033, OR = 3. 846). Conclusion In PTC patients without suspicious lymph node in neck level Ⅱ and Ⅲ by preoperative US, prophylactic level Ⅱ lymph node dissection may not be considered.
