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目的探讨甲状腺乳头状癌患者Ⅵ区淋巴结处理的恰当方案。方法选择2007～2009年60例经术前常规B超、颈部CT检查未见颈部肿大淋巴结的甲状腺乳头状癌患者。60例分为2组:Ⅰ组行原发灶根治+Ⅵ区淋巴结清扫术(30例),Ⅱ组行原发灶根治+Ⅵ区淋巴结清扫术+颈部淋巴结清扫术(30例),术后均服甲状腺素超量抑制内分泌治疗。结果Ⅰ组Ⅵ区淋巴结转移阳性率为36.7%(11/30),Ⅵ区淋巴结转移阳性患者行同侧淋巴结清扫术,淋巴结转移阳性率为25.0%。结论原发灶根治+Ⅵ区淋巴结清扫是治疗甲状腺乳头状癌的一种值得推荐的术式,在原发灶根治术的基础上减少再次手术对甲状腺区的损伤。
Objective To investigate the appropriate regimen of Ⅵ lymph node dissection in patients with papillary thyroid carcinoma. Methods Sixty patients with thyroid papillary carcinoma without neck enlargement lymph node who had undergone conventional B-mode ultrasound and neck CT examination from 2007 to 2009 were selected. Sixty cases were divided into two groups: group Ⅰ was treated with primary tumor radical + Ⅵ lymph node dissection (30 cases), group Ⅱ with primary tumor radical + Ⅵ lymph node dissection + cervical lymph node dissection (30 cases) After serving thyrotrophin excess inhibition of endocrine therapy. Results The positive rate of lymph node metastasis in group Ⅵ was 36.7% (11/30) in group Ⅰ. The positive lymph node metastasis rate was 25.0% in group Ⅵ with lymph node metastasis. Conclusions The radical curative treatment of primary tumor + Ⅵ lymph node dissection is a recommended technique for the treatment of papillary thyroid carcinoma. It can reduce the damage to the thyroid gland area caused by reoperation on the basis of primary radical mastectomy.