Metastatic Trend Of Cervical Lymph Nodes And The Analysis Of Surgical Treatment Of Papillary Thyroid Carcinoma

Objective: Analysis of the thyroid papillary carcinoma clinical pathology andlymph node metastasis characteristics，Explore thyroid papillary carcinoma operationcleaning the range，For neck lymph node dissection time and scope of clinical surgeryprovides an objective basis.Methods: All patients from January1,2008to January1,2011in the FirstAffiliated Hospital of Dalian Medical University were collected，387cases of surgicaltreatment of PTC were analyzed retrospectively. In196cases of PTC，all the casesreceiving modified radical neck dissection，in which18cases only received Ⅵ districtmodified radical neck dissection,117cases received Ⅵ district and unilateral cervicallymph nodes dissection,47cases received Ⅵ district and bilateral cervical lymph nodesdissection,9cases only received unilateral cervical lymph node dissection,5casesreceived bilateral cervical lymph node dissection. In191cases of PTMC,180casesreceiving modified radical neck dissection, in which52cases only received Ⅵdistrictmodified radical neck dissection,102cases received Ⅵdistrict and unilateral cervicallymph nodes dissection，13cases received Ⅵ district and bilateral cervical lymph no-des dissection,7cases only received unilateral cervical lymph node dissection,6casesreceived bilateral cervical lymph node dissection. All statistics SPSS17.0statisticssoftware for statistical analysis, Count data using the χ2test All P <0.05consideredstatistically significant.Results: In196eases of PTC， all eases receiving modified radical neckdissection，in which18cases only received Ⅵ district modified radical neck dissection，7cases had lymph node metastasis,14eases received lateral cervical lymph nodedissection，6cases had lymph node metastasis;164eases received Ⅵ district and lateralcervical lymph nodes dissection，in which79patients showed all had metastasis，31 cases only Ⅵ district had metastasis，and16cases only occurred lateral cervicalmetastasis. In191eases of PTMC，180cases receiving modified radical neckdissection， in which52cases only received Ⅵ district modified radical neckdissection，23cases had lymph node metastasis;13cases only received lateral cervicallymph node dissection，5eases had lymph node metastasis;115cases received Ⅵdistrict and lateral cervical lymph node dissection，in which28patients showed all hadmetastasis，17cases only Ⅵ district had metastasis，and9eases only occurred lateralcervical metastasis.Conclution:1.In PTC, district Ⅵ has a higher lymph node metastasis, and has ahid-den transfer rate, we suggest whatever size of the tumer, should do dissectionsboth the primary focal and Ⅵ district lymph node in the first surgery.2. For the lateralneck area, PTM C if such as the lymph nodes has no doubt before surgery you do notneed prophylactic lateral neck dissection, because of PTC patients have a high lymphnode metastasis, even preoperative clinical examination did not see the lateral cervicallymph node metastases, we also recommend preventive lateral cervical lymph nodedissection:district Ⅱ, Ⅲ,Ⅳ.3. the metastases of district Ⅵ and lateral cervical lymphnode, we can use the metastases of district Ⅵ as a element of predicting lateral cervicallymph node metastases.4. there is a correlation between the diameter of the tumorsize and lateral cervical lymph node, Age factor and lymph node metastasis havecorrelation.5.For coated infringe upon the thyroid carcinoma, the tumor cells are muchmore easoated infringe upon the thyroid cily spread to the lymph drainage neck multiplelymph area，Especially Ⅵ area and Ⅱ, Ⅲ, Ⅳarea.