Abstract：Objective: To explore the clinical characteristics of cervical lateral lymph node metastasis in patients with papillary thyroid carcinoma (PTC), and to perform the analysis on its related risk factors. Methods: The clinical data of 114 PTC patients with suspected lateral cervical lymph node metastasis who were admitted to the hospital between February 2019 and February 2022 were retrospectively selected. The lateral cervical lymph node quantity distribution, metastasis distribution and skip metastasis involving lateral cervical region were statistically analyzed, and the relationship between the clinical characteristics of patients with PTC and the lymph node metastasis in lateral cervical region was analyzed. Results: Among the 114 patients, there were 95 cases of cervical lateral lymph node metastasis and 11 cases of skip metastasis. 1,983 lymph nodes were detected among 95 patients with positive lateral cervical lymph nodes. The lymph node distribution in region Ⅲ was the highest (73. 68%), followed by region Ⅳ (64. 21%) and region Ⅱ (54. 74%) and the lowest in region Ⅴ (12. 63%). Among the 95 patients with PTC, there were 32 cases (33. 68%) of single-region involvement, 41 cases (43. 16%) of double-region involvement, 13 cases (13. 69%) of three-region involvement and 9 cases (9. 47%) of four-region involvement. When PTC lesions were situated in the upper pole, there were 3 cases of single-region involvement, 1 case of double-region involvement and 0 cases of three-region involvement. When PTC lesions were located in the middle pole, there were 2 cases of single-region involvement, 2 cases of double-region involvement and 3 cases of three-region involvement. Univariate analysis showed that the patients with multiple lesions, bilateral lesions, invasive capsule, large tumor diameter and positive central lymph node had higher PTC cervical lateral lymph node metastasis rate (P<0. 05). Multivariate analysis revealed that the risk factor for cervical lateral lymph node metastasis was positive central lymph node metastasis (P<0. 05). Conclusion: The region of cervical lateral lymph node metastasis is in descending order of region Ⅲ, region Ⅳ, region Ⅱ and region Ⅴ. Cervical lateral lymph node metastasis is mainly with multi-regional involvement and with low skip metastasis. Positive central lymph node metastasis is an independent risk factor for cervical lateral lymph node metastasis.
杜镇鸿, 邱红艳. 甲状腺乳头状癌颈侧区淋巴结转移特征及相关危险因素分析[J]. 河北医学, 2022, 28(12): 2038-2043.
DU Zhenhong, et al. Characteristics of Lymph Node Metastasis in the Lateral Cervical Region of Papillary Thyroid Cancer and Analysis of Related Risk Factors. HeBei Med, 2022, 28(12): 2038-2043.
[1] Pu W,Shi X,Yu P,et al.Single-cell transcriptomic analysis of the tumor ecosystems underlying initiation and progression of papillary thyroid carcinoma[J].Nat Commun,2021,12(1):6058. [2] Song L,Zhou J,Chen W,et al.Lymph node metastasis between the sternocleidomastoid and sternohyoid muscle in papillary thyroid carcinoma patients:a prospective study at multiple centers[J].Asian Surg,2021,44(8):1043-1049. [3] 庞凤舜,林淑梅,陈经宝,等.全腔镜下颈侧区淋巴清扫与传统开放手术治疗甲状腺乳头状癌N1b患者的对比研究[J].中国耳鼻咽喉头颈外科,2021,28(4):218-221. [4] Zou Q,Ma S,Zhou X.Association of sonographic features and clinicopathologic factors of papillary thyroid microcarcinoma for prevalence of lymph node metastasis:a retrospective analysis[J].Arch Endocrinol Metab,2021,64(6):803-809. [5] Seok J,Ryu CH,Park SY,et al.Factors affecting central node metastasis and metastatic lymph node ratio in papillary thyroid cancer[J].Otolaryngol Head Neck Surg,2021,165(4):519-527. [6] 王美,王雪格,李利梅.甲状腺乳头状癌颈部淋巴结转移特征及相关影响因素研究[J].实用癌症杂志,2022,37(3):520-522. [7] 杨绍时,周扬,柴慈曼,等.甲状腺微小乳头状癌组织学亚型的临床病理意义及与颈部淋巴结转移的关系[J].天津医药,2022,50(6):638-642. [8] 刘文,董治中,苏艳军,等.甲状腺微小乳头状癌患者颈部中央淋巴结清扫术后假阴性风险概率的评估[J].浙江大学学报(医学版),2021,50(6):722-729. [9] 解琪,辛运超,李栋,等.老年甲状腺乳头状癌患者中央区及颈侧区淋巴结转移的影响因素分析[J].老年医学与保健,2022,28(2):343-348. [10] 廖帅举,刘晓丽,倪卫惠,等.94例甲状腺微小乳头状癌颈部淋巴结转移的影响因素分析[J].东南大学学报(医学版),2022,41(1):132-137.
2022, Vol. 28 
冀公网安备13080202000677号