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目的探讨甲状腺乳头状癌颈部Ⅱb区淋巴结转移规律及相关因素分析。方法回顾性分析2006年1月至2013年1月在广西医科大学附属肿瘤医院接受患侧同期颈淋巴结清扫术的甲状腺乳头状癌患者的临床资料,共纳入能够获得Ⅱa、Ⅱb、Ⅲ、Ⅳ、Ⅴ及Ⅵ区淋巴结转移情况的病人资料共61例,其中3例为双侧甲状腺乳头状癌伴双侧颈部淋巴结转移,共计算64侧颈各区淋巴结转移率,并分析各个临床指标,包括性别、年龄、T分期、颈部各区淋巴结转移率等与Ⅱb区转移的相关性。结果 61例病人,共64侧颈Ⅱ、Ⅲ、Ⅳ、Ⅴ及Ⅵ区淋巴结转移率分别为34.4%(22/64)、43.8%(28/64)、42.2%(27/64)、25.0%(16/64)和48.4%(31/64),其中Ⅱa和Ⅱb区淋巴结转移率分别是25.0%(16/64)和9.4%(6/64)。多因素分析显示Ⅱa区淋巴结转移是Ⅱb区淋巴结转移的独立危险因素。结论甲状腺乳头状癌颈部Ⅱb区淋巴结转移率较低,如果出现Ⅱa区淋巴结转移则Ⅱb区应行常规清扫。
Objective To investigate the rule of lymph node metastasis in Ⅱb area of papillary thyroid carcinoma and its related factors. Methods The clinical data of patients with thyroid papillary carcinoma who underwent ipsilateral cervical lymphadenectomy at Department of Oncology, Guangxi Medical University from January 2006 to January 2013 were retrospectively analyzed. All patients were eligible for Ⅱa, Ⅱb, Ⅲ, Ⅳ, Ⅴ and Ⅵ lymph node metastasis of patients with a total of 61 cases, of which 3 cases of bilateral thyroid papillary carcinoma with bilateral cervical lymph node metastasis, a total of 64 sides of the neck lymph node metastasis rate, and analysis of various clinical indicators, including gender , Age, T stage, cervical lymph node metastasis rate and Ⅱ b area metastasis. Results The metastatic rates of lymph nodes in 61 patients (34.4% (22/64), 43.8% (28/64), 42.2% (27/64), 25.0% (16/64) and 48.4% (31/64), respectively. The rates of lymph node metastasis in group Ⅱa and Ⅱb were 25.0% (16/64) and 9.4% (6/64) respectively. Multivariate analysis showed that lymph node metastasis in IIa was an independent risk factor for lymph node metastasis in IIb. Conclusions The rate of lymph node metastasis in Ⅱb area of papillary thyroid carcinoma is low, and Ⅱb area should be cleaned regularly if there is lymph node metastasis in Ⅱa area.