【摘要】 目的研究中央区淋巴结清扫在甲状腺乳头状微小癌治疗中的意义。方法回顾性分析了复旦大学附属肿瘤医院头颈外科2000-2009年间初治的1048例甲状腺乳头状微小癌病人临床资料,对其中央区转移率及临床诊断情况等进行统计分析。结果甲状腺乳头状微小癌中央区总转移率为38.5%。中央区淋巴结转移与病人性别、年龄、肿瘤多灶性以及肿瘤大小有关。B超及术中临床诊断对中央区淋巴结转移诊断的灵敏度,特异度及准确率为32.2%,77.1%,59.8%。经过随访,颈部淋巴结转移率为1.9%。结论由于甲状腺乳头状微小癌中央区淋巴结转移率相对较高以及术前和术中诊断不足以对中央区转移进行判断,对于甲状腺乳头状微小癌应进行中央区淋巴清扫。更多还原

【Abstract】 Objective To assess the role of central lymph node dissection(CLND) in papillary thyroid microcarcinoma(PTMC). Methods This study included 1048 consecutive PTMC patients who underwent CLND from 2000 to 2009. The data of the incidence of central compartment metastasis, the diagnostic accuracy through ultrasound and intraoperative inspection, the follow-up and the incidence of complication were collected and analyzed. Results The incidence of central compartment metastasis was 38.5%. The status of central compartment metastasis was correlated with major clinicopathologic parameters such as sex, age, multifocal lesions, and the tumor size. The sensitivities, specificities and diagnostic accuracies were 32.2%, 77.1%, 59.8% for the combination of ultrasound and intraoperative inspection, respectively. With a median follow-up of 46.5 months, the metastasis rate was 1.9%(20). Conclusion Considering there was a relatively high rate of central lymph node metastasis, also the sensitivity of preoperative US or intraoperative inspection was not good enough to determine the surgical extent, we suggest that CLND needed to be done even in the low-risk PTMC patients.更多还原