甲状腺滤泡状癌淋巴结微转移与中央组淋巴结处理的探讨
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刘勤江

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The clinical value of lymph node micrometastases in central lymph node group in follicular carcinoma of thyroid
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    摘要:

    目的:从淋巴结微转移的角度探讨甲状腺滤泡状癌中央组(VI组)淋巴结处理的意义。
    方法:选择细胞角蛋白(CK-19)单克隆抗体,应用免疫组化SP法对68例326枚常规病理检查阴性的颈淋巴结(pN0)进行检测,确定其微转移情况并与临床及随访资料进行对比分析。
    结果:326枚pN0 淋巴结中微转移阳性46枚,包括II组4枚(4/42),III组5枚(5/34),IV组5枚(5/49),V组1枚(1/17),VI组31枚(31/184)。在淋巴结微转移阳性的14例中6例(6/14)出现局部复发或远处转移,而54例微转移阴性病人中仅3例(3/54)复发或远处转移(P<0.01)。
    结论:甲状腺滤泡状癌VI组淋巴结是容易发生微转移的区域淋巴结;且淋巴结微转移与肿瘤复发及转移有密切关系。甲状腺滤泡状癌手术时应常规清扫VI组淋巴结。

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    Objective:To evaluate the clinical value of lymph node micrometastases in central group (Ⅵ) lymph node in follicular carcinoma of thyroid.
    Methods :Three hundred and twenty-six negative neck lymph nodes in 68 cases on routine pathological examination(pN0) were examined by keratin-19 monoclonal antibody and S-P immunohistochemistry to detect expression of keratin-19 to confirm lymph node micrometastasis in each neck lymph node, and compare the pathological type and follow-up data of all cases.
    Results:There were 46 neck lymph nodes showed positive lymph node micrometastasis among 326 negative neck lymph nodes that included 4 lymph nodes in group Ⅱ(4/42), 5 lymph nodes in group Ⅲ(5/34), 5 lymph nodes in group Ⅳ(5/49), 1 lymph node in groupⅤ(1/17) and 31 lymph nodes in group Ⅵ(31/184). 6 in 14 cases with positive lymph node micrometastases showed distant metastasis or local recurrence, but only 3 in 54 cases with negative lymph node that micrometastases distant metastasis or local recurrence (P<0.01).
    Conclusions:The research shows that group Ⅵ neck lymph node micrometastasis is easy to occur and is closely related to local recurrence and metastasis in follicular carcinoma of thyroid.

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刘勤江, 田尤新, 马世红.甲状腺滤泡状癌淋巴结微转移与中央组淋巴结处理的探讨[J].中国普通外科杂志,2009,18(5):12-483.
DOI:10.7659/j. issn.1005-6947.2009.05.012

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  • 在线发布日期: 2009-05-25