目的:在分化型甲状腺癌中经常发现淋巴结转移。在术中评估中对显微转移患者的淋巴结进行中心清扫。中央夹层的其他适应症是肿瘤大小和颈外侧淋巴结转移。我们认为甲状腺癌在甲状腺小屋中的定位可能是中央区淋巴结转移的另一个危险因素。出于这个原因,本研究的目的是探讨术前没有宫颈转移并接受全甲状腺切除术的分化型甲状腺癌患者的甲状腺癌定位与淋巴结转移之间的关系。和气管周围,甲状腺周,中央区淋巴结清扫术.
方法:回顾性评估了2016年9月至2020年5月在我们的普外科和内分泌科门诊随访的213例分化型甲状腺癌病例。根据文件中的数据,接受全甲状腺切除术的患者,中央,甲状腺周,和气管周围淋巴结清扫术被纳入研究。根据肿瘤定位将患者分为四组,那些与气管相邻的肿瘤(第1组),甲状腺上极(第2组),甲状腺中部(第3组),甲状腺下位(第4组)。人口特征,实验室参数,癌症类型,并评估各组的淋巴结转移率。
结果:总共84%(179)的病例患有甲状腺乳头状癌,11.73%(25)患有甲状腺滤泡癌,4.2%(9)患有低分化甲状腺癌。所有患者的平均年龄为49±8.3岁,女性/男性比例为2.4。发现分化型甲状腺癌转移到甲状腺周,气管周围,和中央淋巴结的发生率为57.74%。根据各组,这些转移的分布为;第1组为62.85%,第2组为11.53%,第3组为43.9%,第4组为88.57%。还发现,第4组中80.32%的乳头状癌病例和57.14%的滤泡癌病例转移到中央(VI级)淋巴结。
结论:分化型甲状腺癌的定位是甲状腺周围转移的新危险因素。
OBJECTIVE: Lymph node metastasis is frequently detected in differentiated thyroid cancers. Central dissection is performed to the lymph nodes in patients with microscopic metastases in the intraoperative evaluation. Other indications for central dissections are tumor size and cervical lateral lymph node metastasis. We consider that the localization of thyroid cancer in the thyroid lodge may be another risk factor for central lymph node metastasis. For this reason, the purpose of the present study was to investigate the relations between thyroid cancer localization and lymph node metastasis in differentiated thyroid cancer patients who had no preoperative cervical metastases and who underwent total thyroidectomy, and peritracheal, perithyroidal, and central lymph node dissection.
METHODS: A total of 213 differentiated thyroid cancer cases followed in our general surgery and endocrinology clinic between September 2016 and May 2020 were evaluated retrospectively. Based on the data in the files, the patients who underwent total thyroidectomy, and central, perithyroidal, and peritracheal lymph node dissection were included in the study. The patients were divided into four Groups according to tumor localizations, those with tumors adjacent to the trachea (Group 1), upper thyroid pole (Group 2), thyroid middle part (Group 3), thyroid inferior (Group 4). The demographic characteristics, laboratory parameters, cancer types, and lymph node metastasis rates of the Groups were evaluated.
RESULTS: A total of 84% (179) of the cases had thyroid papillary cancer, 11.73% (25) had thyroid follicular cancer, and 4.2% (9) had poorly differentiated thyroid cancer. The mean age of all patients was found to be 49 ± 8.3 years, and the female/male ratio was 2.4. It was found that the differentiated thyroid cancers metastasized to the perithyroidal, peritracheal, and central lymph nodes at a rate of 57.74%. The distribution of these metastases according to the Groups was; 62.85% in Group 1, 11.53% in Group 2, 43.9% in Group 3, and 88.57% in Group 4. It was also found that 80.32% of the papillary cancer cases and 57.14% of the follicular cancer cases metastasized to central (level VI) lymph nodes in Group 4.
CONCLUSIONS: The localization of differentiated thyroid cancers is a new risk factor for perithyroidal metastases.