中国实用外科杂志

中国实用外科杂志

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T1-T2期单侧甲状腺乳头状癌伴同侧颈侧区淋巴结转移时甲状腺原发灶切除范围研究进展

王志宏，张    浩   

  1. 中国医科大学附属第一医院甲状腺外科，辽宁沈阳110001
  • 出版日期:2022-03-01

  • Online:2022-03-01

摘要： 甲状腺乳头状癌（PTC）伴侧颈淋巴结转移并不少见。对于单侧TNM T1-T2期PTC伴同侧颈侧区淋巴结转移者，如不存在淋巴结结外侵犯或转移淋巴结直径≥3 cm等危险因素，甲状腺癌原发灶切除范围的选择存在争议。对于此类病人，甲状腺癌原发灶的切除范围的选择应综合考虑到甲状腺腺体重要的内分泌功能、颈侧区淋巴结转移对预后的影响以及中危组病人为了术后碘治疗而行全甲状腺切除术的必要性。未来对于颈侧区淋巴结转移的病人，应在进行精准的危险分层之后对甲状腺原发灶的切除范围做出合理的选择。

关键词: 甲状腺乳头状癌, 淋巴结转移, 全甲状腺切除, 腺叶切除

Abstract: Progress in the operation scope of unilateral TNM T1 and T2 thyroid papillary carcinoma with lateral cervical lymph node metastasis        WANG Zhi-hong, ZHANG Hao. Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Corresponding author：ZHANG Hao，E-mail:haozhang@cmu.edu.cn
Abstract    Lymph node metastases frequently occur in papillary thyroid carcinoma（PTC）.For patients with unilateral TNM T1-T2 stage PTC with ipsilateral cervical lymph node metastasis，if there are no risk factors such as extranodal lymph node invasion or metastatic lymph node diameter ≥3 cm，the selection of operation scope should take into account the important endocrine function of the thyroid gland，the impact of cervical lymph node metastasis on prognosis and the necessity of total thyroidectomy for postoperative radioiodine ablation therapy. In the future，for patients with lateral cervical lymph node metastasis，a reasonable choice should be made on the scope of thyroid resection after accurate risk stratification.

Key words: papillary thyroid carcinoma, lymph node metastasis, total thyroidectomy, lobectomy