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目的了解甲状腺乳头状微灶癌(PTMC)气管旁淋巴结转移情况,探讨临床颈淋巴结阴性(c N0)PTMC患者发生Ⅵ区淋巴转移的危险因素。方法回顾性分析行患侧甲状腺根治性切除+颈Ⅵ区淋巴清扫术的120例c N0PTMC患者临床资料。根据术后病理检查分为Ⅵ区淋巴结转移组(40例)和未转移组(80例),并对可能的危险因素进行分析研究。结果 PTMC颈Ⅵ区淋巴结转移率为33.3%,单侧癌灶部位(P<0.05)、甲状腺包膜侵犯(P<0.05)、单侧多灶性PTMC(P<0.01)为Ⅵ区淋巴结转移的危险因素。结论 c N0PTMC有较高的颈部中央组淋巴结转移率,在切除甲状腺的同时清扫颈Ⅵ区的淋巴结是十分必要的,尤其有相关危险因素者。
Objective To investigate the status of para-tracheal lymph node metastasis in papillary thyroid carcinoma (PTMC) and to explore the risk factors of lymph node metastasis in zone Ⅵ in patients with clinical cervical lymph node-negative (c N0) PTMC. Methods The clinical data of 120 patients with c N0PTMC who underwent radical thyroidectomy plus neck Ⅵ lymphadenectomy were retrospectively analyzed. According to the postoperative pathological examination, the patients were divided into Ⅵ lymph node metastasis group (40 cases) and non-metastasis group (80 cases), and the possible risk factors were analyzed. Results The rate of lymph node metastasis was 33.3% in cervical Ⅵ region of PTMC, and was significantly higher in unilateral tumor (P <0.05) and thyroid capsule invasion (P <0.05). The unilateral multifocal PTMC (P <0.01) Risk factors. Conclusions c N0PTMC has a higher rate of lymph node metastasis in the central neck. It is necessary to clear the lymph nodes in the neck Ⅵ area while removing the thyroid gland, especially those with related risk factors.