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首页> 外文期刊>Clinical and Experimental Otorhinolaryngology >Is Routine Central Neck Dissection Necessary for the Treatment of Papillary Thyroid Microcarcinoma?
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Is Routine Central Neck Dissection Necessary for the Treatment of Papillary Thyroid Microcarcinoma?

机译：治疗乳头状甲状腺微癌是否需要常规的中央颈清扫术？

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Objectives It remains unclear as to whether routine central neck dissection (CND) is necessary when performing surgery to treat patients with papillary thyroid microcarcinoma (PTMC). To determine the necessity for routine CND in PTMC patients, we reviewed the clinicopathologic and laboratory data of the patients of PTMC. Methods Between September 2001 and July 2005, 101 patients with PTMC and clinical N0 disease were retrospectively reviewed. The study cohort was devided into groups: the total thyroidectomy plus CND group (the CND group, N=48) and the total thyroidectomy without CND group (the no CND group, N=53). The serum stimulated thyroglobulin (Tg) levels were measured after surgery and prior to radioactive iodine ablation therapy (RAI) and at 6-12 months after RAI. Pathology, the Tg levels and recurrence data were compared between the 2 groups. Results Central nodal metastases were found in 18 of the 48 CND patients (37.5%). The incidence of Tg levels >5 ng/mL at RAI was higher in the no CND patients and in the 18 node-positive CND patients compared with the 30 node-negative CND patients (22-24% vs. 3%, respectively, P =0.020-0.058). The difference when performing a similar comparison using a >2 ng/mL Tg threshold level showed no significance (10-11% vs. 4%, respectively, P >0.1). Two of the no CND patients and one node-positive CND patient had recurrences in the thyroid bed or lateral neck during a mean follow-up of 24 months. Conclusion The data showed that occult metastasis to the central neck is common in PTMC patients. A CND provides pathologic information about the nodal metastases, and it potentially provides guidance for planning the postoperative RAI. However, the long-term benefit of CND on recurrence and survival remains somewhat questionable.
机译：目的目前尚不清楚在进行手术治疗甲状腺乳头状微小癌（PTMC）患者时是否需要常规的中央颈清扫术（CND）。为了确定PTMC患者进行常规CND的必要性，我们回顾了PTMC患者的临床病理和实验室数据。方法回顾性分析2001年9月至2005年7月间101例PTMC和临床N0病的患者。研究人群分为两组：全甲状腺切除加CND组（CND组，N = 48）和全无甲状腺的甲状腺切除组（无CND组，N = 53）。在手术后，放射性碘消融治疗（RAI）之前和RAI后6-12个月测量血清刺激的甲状腺球蛋白（Tg）水平。比较两组之间的病理学，Tg水平和复发数据。结果48例CND患者中有18例出现中央结转移，占37.5％。与30例淋巴结阴性的CND患者相比，无CND患者和18例淋巴结阳性的CND患者中RAI的Tg水平> 5 ng / mL的发生率更高（分别为22-24％和3％，P = 0.020-0.058）。使用> 2 ng / mL Tg阈值水平进行相似比较时，差异无显着性（分别为10-11％和4％，P> 0.1）。在平均24个月的随访期间，两名无CND患者和两名淋巴结阳性的CND患者在甲状腺床或颈外侧复发。结论数据显示，PTMC患者常见隐匿性转移至中颈。 CND提供有关淋巴结转移的病理信息，并可能为规划术后RAI提供指导。但是，CND对复发和生存的长期益处仍然存在疑问。

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