摘要
目的 确定甲状腺乳头状腺癌颈淋巴结转移病人手术治疗的效果。方法 对我院１９５４ ～１９８７ 年６２７ 例甲状腺乳头状腺癌行原发癌切除合并颈淋巴结清除术的外科治疗的临床资料进行分析。结果 男１７１ 例，女４５６ 例。平均年龄３７ 岁（６ ～８０ 岁） 。６２７ 例原发癌均已侵出肿瘤包膜。治疗性颈清术３３０ 例，术后病理检查腺内型及腺外型癌颈淋巴结的转移率分别为９６．０２ ％ ，９７．６７ ％ 。选择性（ 预防性） 颈清术２９７ 例，术后病理检查腺内型及腺外型癌颈淋巴结转移率分别为７０．４７ ％ ，７２．０９ ％ 。本组１０ 年以上无瘤生存率为８４．４２ ％ ，其中选择性颈清术组为９４．５２ ％ ，治疗性颈清术组为７５．３１ ％ 。功能性颈清术在相同条件下１０ 年生存率不低于传统性颈清术。结论 颈淋巴结转移是影响预后的重要因素之一；原发癌及颈淋巴结转移癌根治性切除是提高生存率的保障。
Objective To determine surgical effect for papillary thyroid carcinoma with cervical lymph node metastases. Methods A retrospective analysis was made for primary tumor excision combined with cervical lymph node dissection on 627 cases of papillary thyroid carcinoma during 1954 1987. Results There were 171 male cases and 456 female ones in this series. The primary tumor infiltrated beyond the tumor capsule in 627 patients.A therapeutic cervical dissection was performed on 330 cases. The rate of cervical lymph node metastases was 96.02% and 97.67% pathologically in intrathyroid and extrathyroid type carcinoma respectively. A selective cervical dissection was performed on 272 cases. The rate of cervical lymph node metastases was 70.4% and 72.09% in intrathyroid and extrathyroid type carcinoma respectively. 10 years survival without tumor in present group was 84.42% (in patients treated with a selective dissection was 94.52%, with a therapeutic dissection was 75.3%). Under the asme condition, the 10 year survival in patients treated with functional dissection was as the same as treated with classical dissection. Conclusion Cervical lymph node metastases is one of the important prognostic factors, and that complete surgical excixion of primary and metases tumor may be of security in improving the surival rate of the patients.
出处
《中国普通外科杂志》
CAS
CSCD
1999年第5期348-350,共3页
China Journal of General Surgery
关键词
甲状腺肿瘤
乳头状腺癌
淋巴转移瘤
预后
处理
THYROID NEOPLASMS/PP ADENOCARCINOMA,PAPILLARY/PP LYMPHATIC METASTASIS PROGNOSIS
