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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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