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目的探讨中央区淋巴结清扫术在临床颈淋巴结阴性(cN0)甲状腺乳头状癌治疗中的价值。方法对67例cN0甲状腺乳头状癌行原发灶根治性切除,同时行患侧中央区淋巴结清扫术,清扫标本常规送病理检查。结果cN0甲状腺乳头状癌患者中央区淋巴结转移率50.7%(34/67)。中央区淋巴结转移与患者的肿瘤直径≤1.0cm或>1.0cm无关(χ2=0.42,P>0.05);与原发灶是否侵犯包膜(χ2=8.76,P<0.01)及年龄<45岁或≥45岁(χ2=4.30,P<0.05)有关。67例均无喉返神经损伤、永久性低钙抽搐等并发症发生。结论cN0甲状腺乳头状癌行中央区淋巴结清扫术是必要的、安全的处理方式。
Objective To investigate the value of central lymph node dissection in the treatment of clinical cervical lymph node-negative (cN0) thyroid papillary carcinoma. Methods 67 cases of cN0 thyroid papillary carcinoma of the primary tumor radical resection, while the ipsilateral central lymph node dissection, routine cleaning specimens sent pathological examination. Results The central lymph node metastasis rate of cN0 thyroid papillary carcinoma was 50.7% (34/67). Lymph node metastasis in the central region had no relation with tumor diameter ≤1.0cm or> 1.0cm (χ2 = 0.42, P> 0.05), and whether the primary tumor encroached on the capsule (χ2 = 8.76, P <0.01) ≥45 years old (χ2 = 4.30, P <0.05). 67 cases without recurrent laryngeal nerve injury, permanent low calcium convulsions and other complications. Conclusion cN0 thyroid papillary carcinoma of the central lymph node dissection is necessary and safe treatment.