中国医学科学院学报2017，Vol.39Issue(5)：675-681,7.DOI:10.3881/j.issn.1000-503X.2017.05.013
甲状腺乳头状癌原发转移性与复发/持续转移性颈部淋巴结超声特征的比较
Comparison of Ultrasound Features of Primary Metastatic Papillary Thyroid Carcinoma and Recurrent/Persistent Metastatic Cervical Lymph Nodes
摘要
Abstract
Objective To explore the ultrasound features and levels of cervical lymph node metastases in primary and recurrent/persistent papillary thyroid cancer (PTC).Methods We retrospectively analyzed the clinical data of 2181 patients who underwent cervical lymph nodes dissection for PTC from January 1st 2015 to January 1st 2016.Totally 418 PTC patients (with 622 lymph nodes) who met the inclusion criteria entered the final analysis.Patients who had not received any prior thyroid treatment (surgery with or without radioactive iodine) were categorized as the primary group (352 patients with 527 metastatic lymph nodes),and patients who had received prior treatment (thyroidectomy with or without radioactive iodine) for PTC were categorized as recurrent/persistent group (66 patients with 95 metastatic lymph nodes).Pathological results from lymph node dissections were used as the gold standards by means of level-to-level analysis.Results The mean of the minimum axis diameter of the lymph nodes in the primary group was (6.7 ± 3.6) mm,and that of the recurrent/persistent group was (6.6 ± 3.1) mm (U =0.180,P =0.857).The proportion of metastasis in the central area of primary group was 40.0％,which was significantly higher than that in the recurrent/persistent group (12.6％);the proportion of metastasis in the lateral area was 60.6％ in the primary group,which was significantly lower than that in the recurrent/persistent group (87.4％) (x2 =26.288,P ＜ 0.001).In lateral metastatic lymph nodes,Ⅲ level was the most common place in both groups.Level V metastatic lymph was rare in both primary group and recurrent/persistent group.Calcifications (63.1％ vs.48.2％;x2 =7.207,P =0.007) and peripheral vascularity (81.1％ vs.59.4％;x2 =16.147,P ＜0.001) were more common in the recurrent/persistent group.The round shape,absence of an echogenic hilum,hyperechogenicity,and cystic aspects were not significantly different between these two groups (all P ＞ 0.05).Conclusions Primary metastatic lymph nodes often occur in the central area of lymph nodes,while lateral metastatic lymph nodes are more common in recurrent/ persistent PTC.For metastatic lymph nodes,calcifications and peripheral vascularity are more common in recurrent/persistent PTC.关键词
甲状腺乳头状癌/淋巴结/超声/淋巴结分区/转移Key words
papillary thyroid carcinoma/lymph nodes/ultrasound/lymph node levels/metastasis分类
医药卫生引用本文复制引用
徐景竹,赵瑞娜,赖兴建,张晓燕,席雪华,张波,梁智勇,王兴华,李小毅,刘洪枫,吴琼,刘如玉,杨筱,朱沈玲..甲状腺乳头状癌原发转移性与复发/持续转移性颈部淋巴结超声特征的比较[J].中国医学科学院学报,2017,39(5):675-681,7.基金项目
国家自然科学基金(81541131)、国家国际科技合作专项项目(2015DFA30440)和首都卫生发展科研专项基金(2016-2-40110) Supported by the National Natural Sciences Foundation of China (81541131),the International Science and Technology Cooperation Program of China (2015DFA30440),and the Special Fund for Research on Health Development of the Capital (2016-2-40110) （81541131）
