Patterns of lateral and central neck lymph node metastasis in N1b papillary thyroid carcinoma
10.3760/cma.j.cn113855-20201006-00767
- VernacularTitle:N1b的甲状腺乳头状癌侧颈和中央区淋巴结转移规律的研究
- Author:
Yuntao SONG
1
;
Guohui XU
;
Tianxiao WANG
;
Bin ZHANG
Author Information
1. 北京大学肿瘤医院 北京市肿瘤防治研究所头颈外科 恶性肿瘤发病机制及转化研究教育部重点实验室 100142
- Keywords:
Thyroid neoplasms;
Lymphatic metastasis;
Neck lymph node dissection
- From:
Chinese Journal of General Surgery
2021;36(6):410-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the patterns of lateral and central neck lymph node metastasis in N1b papillary thyroid carcinoma (PTC) patients.Methods:From Jun 2018 to Sep 2020, 96 consecutive treatment-naive unilateral N1b PTC patients were included. After total thyroidectomy, bilateral central neck and unilateral lateral neck dissection (including the level Ⅱa, Ⅱb, Ⅲ, Ⅳ and Ⅴb) metastasis in different levels and pathological status of lymph nodes were analyzed.Results:The lymph node metastasis rates were 85% in ipsilateral paratracheal region, 82% in level Ⅲ, 77% in level Ⅳ, 55% in pre-tracheal region, 47% in contralateral paratracheal region, 40% in level Ⅱa, 34% in pre-laryngeal region, 6% in level Ⅱb, 6% in intermuscular region, 4% in level Ⅴb. Tumor size >1cm and pre-tracheal lymph nodes netastasis were associated with contralateral paratracheal metastasis ( OR=3.282 and 3.064, P<0.05); Metastasis to Ⅵa was associated with metastasis to Ⅵb ( OR=3.364, P<0.05). Conclusion:Level Ⅱa-Ⅳ of lateral neck and all subgroups of central neck lymph nodes tend to be involved in PTC with lateral neck metastasis. Lateral neck including level Ⅱa-Ⅳ and the whole central neck including right Ⅵb lymph nodes dissection is recommended for N1b PTC patients.
