关键词: 颈淋巴结转移规律, 甲状腺乳头状癌, 颈部淋巴结清扫术

Abstract:

Objective    To explore the regularity of cervical lymph node metastasis of papillary thyroid carcinoma and to select an appropriate surgical method for papillary thyroid carcinoma. Methods    The clinical data of 616 cases of papillary thyroid carcinoma treated in this hospital between January 2001 and August 2013 were retrospectively analyzed. Results    The total lymph node metastasis rate was 58.77% (362/616). The lymph node metastasis rate was 48.70% (300/616) in level Ⅵ and was 38.80% (239/616) in level Ⅱ,  Ⅲ,  Ⅳ and Ⅴ.  There was significant relationship between the site of the original tumor, maximum diameter, amicula invasion, multifocality, age of patients and cervical lymph node metastasis (P＜0.05). Conclusion    Lymph nodes of level Ⅵ should routinely be dissected in the first surgery in patients with thyroid papillary carcinoma. When the tumor is invaded to amicula, or whose diameter is ＞1.0cm or is multifocality, the cervical lymph node should be dissected and frozen biopsy should be made in the operations to determine the extend of lymphadenectomy.

Key words: Papillary thyroid carcinoma, Neck dissection, Cervical lymph node metastasis