Clinical assessment of neck dissection for cN0 papillary thyroid microcarcinoma
10.3760/cma.j.issn.1674-6090.2015.05.014
- VernacularTitle:cN0期甲状腺乳头状微小癌颈淋巴结清扫范围的临床评价
- Author:
Wenbo GONG
;
Songtao ZHANG
;
Yifei ZHAI
;
Hu HEI
;
Jianwu QIN
- Publication Type:Journal Article
- Keywords:
Papillary thyroid carcinoma;
Microcarcinoma;
Lymph node metastasis;
Neck dissec-tion
- From:
Chinese Journal of Endocrine Surgery
2015;(5):405-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the rule of lymph node metastasis rate in cN 0 papillary thyroid microcar-cinoma( cN0-PTMC) and to evaluate an appropriate region of neck dissection .Methods Data of 233 cases of cN0-PTMC were retrospectively analyzed .Univariate analysis with chi-square test was used to analyze the statisti-cal correlation between gender , age, tumor diameter and lymph node metastasis respectively .Results 81 out of 233 patients(34.8%)had cervical lymph node metastasis (30.0%in central region and 9.9%in lateral region). For patients with tumor diameter ( D)≤5 mm and D>5 mm, lymph node metastasis rate in central region was 21.6%and 36.6%(χ2 =6.199,P<0.05) and it was 4.9% and 13.7% respectively in lateral region (χ2 =5.035,P<0.05).For male and female patients, lymph node metastasis rate in central region was 42.1% and 26.1%respectively(χ2 =5.224,P<0.05), and it was 21.1% and 6.3% respectively in lateral region (χ2 =10.604,P<0.01).Lymph node metastasis rate in patients≤45 years old and >45 years old was 37.9% and 21.1% respectively (χ2 =7.792, P <0.01 ) .The lateral region lymph node metastasis rate was 17.1% and 6.7%when the central region lymph node was infringed or not (χ2 =5.947, P<0.05).Conclusions All cN0-PTMC patients should have a normative central neck dissection .Male patients with PTMC and tumor diameter >5 mm should receive the lateral neck lymphoid tissue exploration during surgery in order to find subclinical metas -tasis.
