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目的:探讨甲状腺乳头状微小癌颈部淋巴结转移的相关因素,以及一期手术时行择区性淋巴结清扫术的意义。方法:甲状腺乳头状微小癌患者82例中,术中冷冻病理诊断为甲状腺乳头状微小癌者60例(第1组),行择区性颈淋巴结清扫术;术中冷冻病理诊断为甲状腺良性疾病者22例(第2组),未行择区性淋巴结清扫术。结果:行择区性颈淋巴结清扫术60例中,13例(21.67%)出现颈部淋巴结转移;最大直径<0.7cm与≥0.7cm的肿瘤转移率分别为4.76%和30.77%,差异有统计学意义(P<0.05)。所有患者平均随访59.8个月,无复发和死亡,未发现远处转移。结论:甲状腺乳头状微小癌具有一定比例的颈部淋巴结转移率,尤其对于肿瘤最大直径≥0.7cm者行择区性淋巴结清扫术是更有效的治疗方法。
Objective: To investigate the related factors of cervical lymph node metastasis of papillary thyroid carcinoma and the significance of selective lymph node dissection in primary surgery. Methods: Among 82 patients with papillary thyroid carcinoma, intraoperative frozen pathology was diagnosed as thyroid papillary microcarcinoma in 60 cases (group 1) with regional cervical lymphadenectomy. Intraoperative frozen pathology was diagnosed as thyroid benign disease In 22 cases (group 2), no regional lymph node dissection was performed. Results: Of the 60 cases who underwent selective cervical lymph node dissection, cervical lymph node metastasis occurred in 13 cases (21.67%). The tumor metastasis rates were 4.76% and 30.77% in the cases with the largest diameter <0.7cm and ≥0.7cm, respectively Significance (P <0.05). All patients were followed up for an average of 59.8 months without recurrence and death, and no distant metastasis was found. Conclusion: Papillary thyroid carcinoma has a certain proportion of cervical lymph node metastasis rate, especially for the tumor with a maximum diameter of 0.7cm orginal lymph node dissection is a more effective treatment.