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《Chinese Journal of Bases and Clinics in General Surgery》 2014-01
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Pattern and Predictive Factors of Neck Lymph Node Metastasis in Papillary Thyroid Carcinoma

SHI Chen-lei;SHI Tie-feng;QIN Hua-dong;The Fourth Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University;  
Objective To evaluate the pattern and predictive factors of regional lymph node metastasis in papillay thyroid carcinoma( PTC). Methods The clinical data of 223 patients with PTC whom suffered operation from Dec. 2008to Dec. 2011 in our hospital were retrospective analyzed. The relationship among the lymph node metastasis of different area of the neck and patient's sex, age, preoperative TSH level, tumor size, multifocality, extracapsular spread, Hashimoto thyroiditis, nodular goiter, and the T classification of the tumors were analyzed. Results The univariate analysis results showed that patient's age ≥45 years old and associated with nodular goiter were statistically significantly related to central lymph node metastasis( P0.05), for lateral lymph node metastases, the multifocality were statistically significant(P0.05). The multivariate analysis results showed that patient's age ≥45 years old and associated with nodular goiter were protective factors for central lymph node metastasis( P0.05), for lateral lymph node metastasis, the multifocality was risk factor( P0.05). Most of the lateral lymph node metastases were confined to levels Ⅱ-Ⅳ, and the incidence oflevel Ⅲ was as highest as 100%. When the skip metastasis, the levels Ⅱ-Ⅳ were the transfer of high incidence areas.Conclusions When age 45 years old of patients with PTC, the central neck dissection should be routine performed. The incidence of central lymph node metastasis will decrease if associated with nodular goiter. Because multifocality is a risk factor for lateral lymph node metastasis, careful inspection levels Ⅱ-Ⅳ should be performed during operation, especially level Ⅲ lymph nodes. If skip metastasis is present, levels Ⅱ-Ⅳ dissection would be a proper treatment option.
【Fund】: 黑龙江省自然科学基金资助(项目编号:D201228);; 哈尔滨医科大学附属第二医院青年基金资助(项目编号:QN2012-07)~~
【CateGory Index】: R736.1
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【Citations】
Chinese Journal Full-text Database 1 Hits
1 ;Selection of Neck Dissection to Differentiated Thyroid Carcinoma[J];Chinese Journal of Bases and Clinics in General Surgery;2010-08
【Co-citations】
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1 LIU Ya-Qi;SANG Chang-Ye;XU Yi-Zhuang;XU Zhi;ZHOU Xiao-Si;LING Xiao-Feng;Department of General Surgery,Third Hospital of Peking University;Department of General Surgery,Beijing Jishuitan Hospital;Department of General Surgery,Beijing Yanqing Hospital;College of Chemistry Molecular Engineering,Peking University;;Detection of Micro-metastatic Lymph Node in Thyroid Cancer by Fourier Transform Infrared Spectroscopy[J];Chemical Journal of Chinese Universities;2013-10
2 Ru-Hai Zou;Qi-Jiong Li;Ji-Liang Qiu;Ya-Di Liao;Yun-Fei Yuan;An-Hua Li;State Key Laboratory of Oncology in South China;Department of Ultrasound,Sun Yat-sen University Cancer Center;Department of Hepatobiliary Oncology,Sun Yat-sen University Cancer Center;;A modified radiofrequency ablation approach for treating distant lymph node metastasis in two patients with late-stage cancer[J];癌症(英文版);2013-10
3 XIONG Ying,ZHANG Bo,LI Jianchu Department of Ultrasound,Civil Aviation General Hospital,Beijing 100025,China;Value of ultrasound in diagnosis of enlarged cervical lymph nodes[J];Journal of Ultrasound in Clinical Medicine;2010-06
4 PAN Ye, ZOU Jian-hua, ZHENG Qi, FAN You-ben, WU Bo Department of General Surgery , Shanghai No.6 people’s Hospital of Shanghai Jiaotong University(Shanghai 200233 , China);Meta-analysis of the security of thyroidectomy combined with prophylactic central neck dissection[J];Chinese Journal of Current Advances in General Surgery;2010-01
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