Study on lymph node metastasis in level Ⅱ of thyroid papil-lary carcinoma with positive lymph nodes in level Ⅳ(nega-tive in level Ⅲ and Ⅴ)
10.3969/j.issn.1009-9905.2024.12.004
- VernacularTitle:甲状腺乳头状癌颈Ⅳ区阳性(Ⅲ区Ⅴ区阴性)时Ⅱ区淋巴结转移的研究
- Author:
Sheng-qian XU
1
;
Guo-hua ZHU
1
;
Jian-feng CHENG
1
;
Yan ZHOU
1
Author Information
1. 江苏省原子医学研究所附属江原医院 普外科(江苏 无锡 214063)
- Publication Type:Journal Article
- Keywords:
Papillary thyroid carcinom;
Lymph node metastasis;
Level Ⅳ;
Level Ⅱ
- From:
Chinese Journal of Current Advances in General Surgery
2024;27(12):943-947
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influencing factors of level Ⅱ lymph node metastasis in patients with thyroid papillary carcinoma(PTC)with positive level Ⅳ(level Ⅲ and Ⅴ negative),and to evaluate the feasibility of superselective cervical lymph node dissection.Methods:This study was retrospectively analyzed the clinicopathological data of 173PTC patients with level Ⅳ positive(level Ⅲ and V negative)who underwent cervical lymph node dissection in our hospital.We also studied the effects of related factors such as age,sex,tumor size,tumor location,number of lymph node metastasis in level Ⅵ and Ⅳon lymph node metastasis in level Ⅱ.Results:The overall metastatic rate of level Ⅱ lymph nodes was 19.6％.Univariate analysis showed that single tumor,lower pole tumor,lower pole tumor with a maximum diameter less than 1.0cm,less than 2 lymph node metastases in level Ⅵ+Ⅳ were significantly negatively correlated with lymph node metasta-sis in level Ⅱ(P＜0.05);There was no significant correlation between skip lymph node metastasis in central region,tumor size+number of lymph node metastasis in level Ⅵ,sex,age,tumor size,and number of lymph node metastasis in level Ⅳ and Ⅵ,and lymph node metastasis in level Ⅱ(P＞0.05).Further analysis showed that when the tumor was＜1.0cm and there was no lymph node metastasis in central region,no metastasis was found in level Ⅱ lymph nodes.Multivariate analysis:Upper pole tumor was an independent risk factor for level Ⅱ lymph node metastasis(OR=8.023,P＜0.001).The risk of level Ⅱ lymph node metastasis was higher in patients with middle pole tumor(OR=2.014,P=0.207)or multiple tumors(OR=2.163,P=0.083).And the risk of level Ⅱ lymph node metastasis was lower in patients with skip metastasis in central region(OR=0.316,P=0.100).Con-clusion:For patients with positive cervical level Ⅳ of PTC(negative for level Ⅲ and V),lower ex-tremal tumor,especially＜1.0 cm,or papillary thyroid microcarcinoma(PTMC)without central lymph node metastasis(CLNM),or single lymph node metastasis in cervical region Ⅳ without CLNM,the metastasis rate of cervical region Ⅱ lymph node is relatively lower.lf there are no high risk factors of level Ⅱ lymph node metastasis,superselective cervical lymph node dissection may be performed.
