CN0PTC Lymph Node Occult Metastasis Factor Analysis And The Significance Of The Central Neck Lymph Node Dissection

Objective: Papillary thyroid carcinoma is the most common type of thyroidcancer, accounting for80%of thyroid cancer, its incidence is also increasing at thespeed of about6percent a year, the onset than the occult, the low degree of malignancy,longer duration, and there is strong regional lymph node metastasis tendency, surgery isthe main treatment, patients often take a different surgical approach according to thetumor biological characteristics.Has been confirmed on clinical cervical lymphnode-positive (cN+) of papillary thyroid carcinoma underwent combined radical surgeryis no longer dissent, but the introduction of a lymph node-negative patients with clinicalneck lymph node dissection, selective neck dissection, sweeping the timing remainscontroversial. In this study, cervical lymph node negative (cN0) of papillary thyroidcarcinoma patients with surgical neck lymph node processing appropriate program.Methods: Retrospective analysis from January2008to December2010were168cases of clinical cervical lymph node-negative papillary thyroid cancer patients. OKpapillary thyroid carcinoma primary lesions radical lymph node dissection of the+ipsilateral Central District (R+D)78cases of. Only the line of the primary tumor90cases of radical surgery (R). Tumor size, capsule invasion and central neck lymph nodemetastasis with or without correlation to explore the significance of cN0PTC centralneck lymph node dissection. Oral thyroid hormone endocrine therapy after operation,periodic neck ultrasonography, tracking cervical lymph node metastasis.Results: R+D group detected in lymph nodes1-12gold, lymph node detectionrate of an average of3per cases, the central neck lymph node-positive rate of53.8%(42/78). Primary lesion invaded the capsule central neck lymph node-positive rate was77.8%(14/18); not leaching capsule central lymph node positive rate was46.7%(28/60). Tumor diameter>1.0cm central neck lymph node positive rate was69.6% (39/56), tumor diameter <1.0cm central neck lymph node-positive rate was13.6%(3/22). Without evidence of recurrence, the Group B tumor recurrence in two cases bothsides of neck lymph node metastasis, underwent secondary surgery.Conclusion: Clinical neck lymph node-negative (cN0) lymph node dissection,papillary thyroid carcinoma in patients with the central area,53.8%of patients withoccult metastasis, tumor diameter greater than1cm, capsule invasion were significantlyhigher transfer rate (P<0.05), there are statistically significant. So PTC original tumorcure+ipsilateral central lymph node dissection is the treatment of of cN0thyroidpapillary adenocarcinoma surgical approach should be promoted, this surgical approachcan not only accurately PTC tumor stage, but also to avoid the second surgery, cervicallymph node when cleaning the recurrent laryngeal nerve injury.