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目的:探讨分化型甲状腺癌(DTC)颈内静脉旁淋巴转移的特点,以及手术治疗中颈内静脉旁淋巴结活检的意义。方法:回顾性分析2006年1月―2012年6月间根治术中行颈内静脉旁淋巴结活检的98例(106侧)DTC患者临床病理资料。根据术前临床体检和影像学检查结果分为临床颈侧区淋巴结转移阳性(cN1b)和阴性(cN0)两组,分别与术后病理结果作比较。结果:106侧颈内静脉旁淋巴结活检阳性者46侧(43.4%),其中cN1b组56侧阳性者39侧(69.6%),cN0组50侧阳性者7侧(14.0%);假阳性率28.3%(17/60),假阴性率15.2%(7/46)。结论:DTC颈内静脉旁淋巴结转移常见;术前判断有无颈侧区淋巴结转移存在不足,建议在DTC根治术中常规行颈内静脉旁淋巴结活检。
Objective: To investigate the characteristics of paraffin-embedded lymph node metastasis of differentiated thyroid carcinoma (DTC) and the significance of biopsy of adjacent jugular vein lymph nodes in surgical treatment. Methods: The clinical and pathological data of 98 cases (106 sides) of DTC patients undergoing radical jugular vein lymph node biopsy from January 2006 to June 2012 were analyzed retrospectively. According to preoperative clinical physical examination and imaging findings were divided into clinical cervical lymph node metastasis positive (cN1b) and negative (cN0) two groups were compared with postoperative pathological results. Results: 46 sides (43.4%) were positive in 106 lateral jugular vein lymph node biopsy specimens, of which 39 (69.6%) were positive in 56 cN1b and 7 (14.0%) in 50 cN0, while the false positive rate was 28.3 % (17/60), false negative rate of 15.2% (7/46). CONCLUSION: DTC is common in the jugular vein adjacent to the lymph nodes. Preoperative judgment of the presence or absence of lymph node metastasis in the neck region suggests that it is recommended to routinely perform biopsy of the jugular vein lymph node in DTC.