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目的:探讨临床颈淋巴结阴性(cN0)甲状腺乳头状癌患者中央区淋巴结转移的规律。方法:123例cN0甲状腺乳头状癌患者均行中央区淋巴结清扫(Ⅵ区),47例行单侧颈淋巴结清扫术,9例行双侧颈淋巴结清扫术。结果:78例(63.4%)中央区淋巴结阳性,其中34例(27.6%)双侧中央区淋巴结阳性。中央区淋巴结转移与年龄<45岁、被膜侵犯、周围组织侵犯及肿瘤大小分级相关(P<0.05)。结论:年龄<45岁、被膜侵犯、周围组织侵犯是中央区淋巴结转移的独立危险因素。对cN0甲状腺乳头状癌建议同期行原发灶切除和中央区淋巴结清扫术;根据术中冷冻结果和术中情况决定进一步的处理。
Objective: To investigate the central lymph node metastasis in patients with clinical cervical lymph node negative (cN0) papillary thyroid carcinoma. METHODS: A total of 123 patients with cN0 thyroid papillary carcinoma underwent central lymph node dissection (VI), 47 underwent unilateral cervical dissection, and 9 underwent bilateral cervical lymph node dissection. Results: 78 patients (63.4%) had positive lymph nodes in the central area, 34 of whom (27.6%) had positive bilateral lymph nodes. Central lymph node metastasis was associated with age <45 years, capsule invasion, surrounding tissue invasion and tumor size and grade (P<0.05). CONCLUSIONS: Age <45 years, encroachment of the capsule, and invasion of surrounding tissues are independent risk factors for lymph node metastasis in the central region. Primary tumor resection and central lymph node dissection are recommended for cN0 papillary thyroid carcinoma at the same time; further treatment is determined based on intraoperative frozen results and intraoperative conditions.