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目的分析CN0期甲状腺微小乳头状癌的临床特征和预后,探讨其中央区淋巴结清扫的临床意义。方法回顾分析2005年9月至2011年12月手术治疗的35甲状腺微小乳头状癌患者的临床资料,入组标准为临床判定颈部淋巴结阴性,并且癌灶未侵破腺体被膜。结果 35例患者均行患侧腺叶加峡叶切除并联合同侧中央区淋巴结清扫,术后病理检查发现其中15例患者伴有淋巴结转移(42.9%),平均随访3.5年,1例患者术后出现对侧叶复发,1例出现患侧颈部4区淋巴结转移复发。结论甲状腺微小乳头状癌中央区转移率较高,即使术前判断为CN0,仍需行中央区淋巴结清扫。
Objective To analyze the clinical features and prognosis of CN0 thymic papillary carcinoma and to explore the clinical significance of lymph node dissection in central region. Methods The clinical data of 35 patients with microscopic papillary thyroid carcinoma surgically treated from September 2005 to December 2011 were retrospectively analyzed. The criteria for inclusion were clinically determined negative for cervical lymph nodes, and the lesions did not break through the glandular capsule. Results All the 35 patients underwent lobectomy combined with lobectomy and ipsilateral central lymph node dissection. Fifteen patients with lymph node metastasis (42.9%) were found after pathological examination, with an average follow-up of 3.5 years. One patient had postoperative The recurrence of the contralateral lobe, ipsilateral neck 4 cases of lymph node metastasis recurrence. Conclusions The metastatic rate of central papillary thyroid papillary carcinoma is high. Even if it is preoperatively determined as CN0, central lymph node dissection is still required.