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医学临床研究  2021, Vol. 38 Issue (8): 1208-1210    DOI: 10.3969/j.issn.1671-7171.2021.08.026
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CLND手术在cN0期DTC患者中的应用价值及中央区淋巴结转移的相关因素分析
王小芳a, 刘巧艳b, 姚佳a
陕西省蓝田县人民医院:a.感染科;b.消化科,陕西 蓝田 710500
Application Value of CLND in Patients with cN0 DTC and Analysis of Related Factors of Central Lymph Node Metastasis
WANG Xiao-fang, LIU Qiao-yan, YAO Jia
Lantian Country People's Hospital, xi'an 710500,Shaanxi
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摘要 【目的】探讨中央区淋巴结清扫(CLND)在cN0期(颈淋巴结阴性)分化型甲状腺癌(DTC)手术中的应用价值及中央区淋巴结转移的相关因素。【方法】回顾性分析2016年4月至2019年4月本院行手术治疗的140例cN0期DTC患者,根据手术过程中是否行CLND术将其分为观察组(n=80,手术过程中行CLND术)和对照组(n=60,手术过程中未行CLND术)。比较两组患者手术后声音嘶哑、低钙血症、局部复发、再次手术的发生情况,并对实施了CLND手术的80例患者获取的中央区淋巴结进行病理学检查,分析cN0期DTC患者发生中央区淋巴结转移的相关因素。【结果】观察组和对照组术后声音嘶哑、低钙血症发生率比较,差异无统计学意义(P>0.05);经过36个月随访,对照组术后局部复发率、再次手术率均高于观察组,差异有统计学意义(P<0.05)。观察组80例患者实施中央区淋巴结清扫,术后病理学检查发现有23例患者中央区淋巴结转移阳性(阳性组),57例患者中央区淋巴结为阴性(阴性组),经单因素分析发现cN0期DTC病灶>1.0 cm、发生包膜侵犯与中央区淋巴结转移有关(P<0.05)。【结论】cN0期DTC患者病灶>1.0 cm、发生包膜侵犯与中央区淋巴结转移有关,实施CLND手术对于降低cN0期DTC患者术后局部复发具有积极作用。
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作者相关文章
王小芳
刘巧艳
姚佳
关键词 甲状腺肿瘤/外科学淋巴转移肿瘤分期淋巴结切除术/方法危险因素    
Abstract:【Objective】To investigate the value of central lymph node dissection (CLND) in the operation of cN0 (cervical lymph node negative) differentiated thyroid cancer (DTC) and the related factors of central lymph node metastasis. 【Methods】A total of 140 patients with cN0 DTC who underwent surgery in our hospital from April 2016 to April 2019 were retrospectively analyzed. According to whether CLND was performed during the operation, they were divided into observation group (n=80, CLND was performed during the operation) and control group (n=60, CLND was not performed during the operation). The occurrence of hoarseness, hypocalcemia, local recurrence and reoperation were compared between the two groups. The central lymph nodes obtained from 80 patients undergoing CLND were examined pathologically, and the related factors of central lymph node metastasis in patients with cN0 DTC were analyzed. 【Results】 There was no significant difference in the incidence of hoarseness and hypocalcemia between the observation group and the control group (P>0.05); After 36 months of follow-up, the local recurrence rate and reoperation rate in the control group were higher than those in the observation group (P<0.05). 80 patients in the observation group underwent central lymph node dissection. Postoperative pathological examination found that 23 patients had positive central lymph node metastasis (positive group) and 57 patients had negative central lymph nodes (negative group). Univariate analysis showed that cN0 DTC lesions > 1.0 cm and capsule invasion were related to central lymph node metastasis (P<0.05). 【Conclusion】The focus > 1.0 cm and capsule invasion in patients with cN0 DTC are related to central lymph node metastasis. CLND operation plays a positive role in reducing postoperative local recurrence in patients with cN0 DTC.
Key wordsThyroid Neoplasms/SU    Lymphatic Metastasis    Neoplasm Staging    Lymph Node Excision/MT    Risk Factors
收稿日期: 2019-08-26     
中图分类号:  R736.1  
引用本文:   
王小芳, 刘巧艳, 姚佳. CLND手术在cN0期DTC患者中的应用价值及中央区淋巴结转移的相关因素分析[J]. 医学临床研究, 2021, 38(8): 1208-1210.
WANG Xiao-fang, LIU Qiao-yan, YAO Jia. Application Value of CLND in Patients with cN0 DTC and Analysis of Related Factors of Central Lymph Node Metastasis. JOURNAL OF CLINICAL RESEARCH, 2021, 38(8): 1208-1210.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.08.026     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I8/1208
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