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目的探讨中央区淋巴结清扫术在甲状腺乳头状癌中的应用价值。方法回顾性分析我院192例初次诊治且术前无任何局部并发症的甲状腺乳头状癌患者临床病理资料。结果本组患者总体颈部淋巴结转移率为52.1%,中央区淋巴结转移率为50.0%。微小癌组与非微小癌组颈部淋巴结转移率分别为44.1%、66.7%,中央区淋巴结转移率分别为43.3%、63.1%。微小癌组与非微小癌组淋巴结转移发生率有明显差异(χ2=9.593,P<0.05)。微小癌组中,原发灶大小对淋巴结转移率无明显影响(χ2=0.982,P>0.05),多发灶患者较单发灶者更容易出现颈淋巴结转移(χ2=4.334,P<0.05)。结论非微小甲状腺乳头状癌应常规进行中央区淋巴结清扫术,微小甲状腺癌也应建议中央区淋巴结清扫术。
Objective To investigate the value of central lymphadenectomy in papillary thyroid carcinoma. Methods A retrospective analysis of our hospital 192 cases of initial diagnosis and treatment of thyroid papillary carcinoma without any local complications of clinical and pathological data. Results The overall rate of cervical lymph node metastasis in this group was 52.1% and the rate of central lymph node metastasis was 50.0%. The rate of cervical lymph node metastasis was 44.1% and 66.7% in micro-cancer group and non-micro-cancer group, respectively. The rate of lymph node metastasis in central area was 43.3% and 63.1% respectively. The incidence of lymph node metastasis between micro-cancer group and non-micro-cancer group was significantly different (χ2 = 9.593, P <0.05). In the minimally invasive cancer group, the size of the primary tumor had no significant effect on the lymph node metastasis rate (χ2 = 0.982, P> 0.05). Multiple neck lesions were more likely to have cervical lymph node metastasis than single lesions (χ2 = 4.334, P <0.05). Conclusion Non-mini thyroid papillary carcinoma should be performed routine lymphadenectomy in the central area. Minimal thyroid cancer should be recommended for central lymphadenectomy.