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目的 确定甲状腺乳头状腺癌颈淋巴结转移病人手术治疗的效果。方法 对我院１９５４ ～１９８７ 年６２７ 例甲状腺乳头状腺癌行原发癌切除合并颈淋巴结清除术的外科治疗的临床资料进行分析。结果 男１７１ 例，女４５６ 例。平均年龄３７ 岁（６ ～８０ 岁） 。６２７ 例原发癌均已侵出肿瘤包膜。治疗性颈清术３３０ 例，术后病理检查腺内型及腺外型癌颈淋巴结的转移率分别为９６．０２ ％ ，９７．６７ ％ 。选择性（ 预防性） 颈清术２９７ 例，术后病理检查腺内型及腺外型癌颈淋巴结转移率分别为７０．４７ ％ ，７２．０９ ％ 。本组１０ 年以上无瘤生存率为８４．４２ ％ ，其中选择性颈清术组为９４．５２ ％ ，治疗性颈清术组为７５．３１ ％ 。功能性颈清术在相同条件下１０ 年生存率不低于传统性颈清术。结论 颈淋巴结转移是影响预后的重要因素之一；原发癌及颈淋巴结转移癌根治性切除是提高生存率的保障。
Objective To determine the effect of surgical treatment of cervical lymph node metastases in papillary thyroid carcinoma. Methods The clinical data of primary surgical resection of 627 cases of thyroid papillary adenocarcinoma in our hospital from 1954 to 1987 were analyzed. Results There were 171 males and 456 females. The average age is 37 years old (6-80 years old). All 627 cases of primary cancer had invaded the tumor capsule. Among the 330 patients with therapeutic neck dissection, the metastatic rates of cervical lymph nodes in the intra- and intra-adenocarcinoma tissues were 96.02 % and 97.67%, respectively. Selective (preventive) cervical dissection was performed in 297 patients. Postoperative pathological examination revealed that the rate of cervical lymph node metastasis was 70.47 % and 72.09 %, respectively. The disease-free survival rate of this group over 10 years was 84.42%, including 94.52% in the selective neck dissection group and 75.31% in the therapeutic neck dissection group. The 10-year survival rate of functional neck dissection under the same conditions is not lower than that of traditional neck dissection. Conclusions Cervical lymph node metastasis is one of the important factors affecting prognosis. Radical resection of primary cancer and cervical lymph node metastasis is the guarantee of improving survival rate.