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目的探讨Ⅵ区淋巴结清扫在cN0分化型甲状腺癌治疗中的价值。方法回顾性分析笔者所在医院2003年1月～2005年12月收治的84例cN0分化型甲状腺癌且行Ⅵ区淋巴结清扫术的病例资料。对照2000年1月～2002年12月收治的61例cN0分化型甲状腺癌且未行Ⅵ区淋巴结清扫术的病例资料分析。结果 cN0分化型甲状腺癌Ⅵ区淋巴结转移阳性率为53.6%(45/84);5年内出现同侧颈侧区淋巴结转移率为4.8%,再次行颈侧区清扫术,无喉返神经损伤,无永久性低钙抽搐;对照组5年内出现颈部淋巴结转移率为19.68%,行颈部淋巴结清扫出现喉返神经损伤及甲状旁腺损伤率情况与实验组比较,差异有统计学意义(P<0.01)。结论 cN0分化型甲状腺癌行Ⅵ区淋巴结清扫术是必要的,有效的,安全的处理方法。
Objective To investigate the value of Ⅵ lymph node dissection in the treatment of cN0 differentiated thyroid cancer. Methods A retrospective analysis of the author’s hospital from January 2003 to December 2005 admitted 84 cases of cN0 differentiated thyroid cancer and line Ⅵ regional lymph node dissection data. Sixty-one cases of cN0-differentiated thyroid cancer who underwent surgery from January 2000 to December 2002 were analyzed retrospectively. Results The positive rate of lymph node metastasis in Ⅵ of cN0 differentiated thyroid carcinoma was 53.6% (45/84). The rate of lymph node metastasis in ipsilateral neck was 5% within 4.8 years. The neck dissection was performed again without recurrent laryngeal nerve injury, There was no permanent low calcium convulsion. In the control group, the rate of cervical lymph node metastasis within 5 years was 19.68%. The recurrent laryngeal nerve injury and parathyroid injury rate in cervical lymph node dissection were significantly different from those in experimental group (P <0.01). Conclusion cN0 differentiated thyroid carcinoma line Ⅵ lymph node dissection is necessary, effective and safe treatment.