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1、微小乳头状甲状腺癌淋巴结转移规律及术式的研究朱武东1杨进平2邓光华1梁霖1(1广东省高州市分界镇中心卫生院普通外科525248)(2广东省高州市中医院外三科525200)【摘要】目的：探究微小乳头状甲状腺癌淋巴结的转移规律及手术方式的选择。方法:综合分析2007年4月至2010年1只期间我院收治的150例微小乳头状甲状腺癌患者的淋巴转移规律和不同手术方法的临床效果。结果：所有选取的病例都接受常规甲状腺双侧全切加颈深(III+IVK)组及中央(VI区)组颈部淋巴结清扫术[1],手术治愈率高、创伤小，手术效果十分理想。微小乳头状甲状腺癌淋巴结转移主要和患者的年龄、肿瘤原发灶
2、数量、肿瘤直径、发病区域等有直接关系。结论：微小乳头状甲状腺癌是临床中最常见的淋巴结转移发生在中央组(V1IX)淋巴结，其次发生在颈深组(m+ivix)的淋巴结比较多，初次进行手术治疗的患者应对双侧中央组淋巴结进行常规清扫，当肿瘤直径〉lcm或者出现肿瘤突破甲状腺包膜、侵犯肌肉时，要同时清扫同侧的颈深组淋巴结。【关键词】甲状腺癌乳头状癌淋巴结转移【中图分类号】R73-3【文献标识码】A【文章编号】2095-1752(2013)25-0174-02ClinicalResearchonRegularityofLymphNodeMetastasisandtheselectio
3、nofsurgicalprocedureinMicroPapillaryThyroidCarcinomaZhuWudong1,YangJinhua2,DengGuanghual,LiangLinl1.DepartmentofGeneralsurgery,Fenjietowncenterhospital,MaomingGuangdong525248;2.Departmentofthethreesurgerysubjects,GaozhouTraditionChineseMedicineHospital,MaomingGuangdong525200[Abstract]Obj
4、ective:Toexplorethemicropapillarythyroidcancerlymphnodemetastasisandtheselectionofsurgicalprocedure.Methods:Comprehensiveanalyzethelymphnodemetastasisinclinicaleffectsofdifferentsurgicalmethodsof150casesofpapillarythyroidcancerfromApril,2007toJanuary,2010inourhospital.Results:Allpatients
5、werereceivingconventionalselectedshaverthyroidbilateraldeepcervical(III+IVarea)groupandcentral(VIarea)groupcervicallymphnodedissection.Theoperationissafeandsurgicalresultsarequitesatisfactory.Micropapillarythyroidcarcinomaandlymphnodemetastasisinpatientswithprimaryage,thenumberofprimaryt
6、umor,tumordiameter,whicharedirectlyrelated[2].Conclusion:Micropapillarythyroidcarcinomaisthemostcommonclinicaloccurrenceoflymphnodemetastasisinthecentralgroup(VIarea)lymphnodes,andthesecondhigheroccurredinthedeepjugular(III+IVarea),theinitialsurgicaltreatmentofpatientsrespondtodoubleside
7、routinecentrallymphnodedissection,whenthetumordiameter>1cmoratumorbreakthroughthyroidcapsule,violationofthemuscles,weneededtocleantheipsilateraldeepcervicallymphnodesinthesameway.【Keywords】ThyroidneoplasmPapillarycarcinomaLymphaticmetastasis据不完全统计，90%以上的甲状腺癌患者属于乳头状甲状腺癌
