Ultrasonographically and anatomopathologically detectable node metastases in the lateral compartment as indicators of worse relapse-free survival in patients with papillary thyroid carcinoma
Ultrasonographically and anatomopathologically detectable node metastases in the lateral compartment as indicators of worse relapse-free survival in patients with papillary thyroid carcinoma
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DOI：
10.1007/s00268-005-7789-x
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发表时间：
2005-07-01
影响因子：
2.6
通讯作者：
Miyauchi, A
中科院分区：
文献类型：
--
作者：
Ito, Y;Tomoda, C;Miyauchi, A
近年来，超音波检查的盛行，使得甲状腺癌外侧间室淋巴结转移的侦测更为容易。在这项研究中，我们调查了560例直径> 1 cm的乳头状癌患者术前超声（US）可检测到的外侧淋巴结转移和术前病理检查未检测到的转移[解剖病理学（AP）可检测的转移]对预后的影响，这些患者在我院接受了甲状腺切除术和改良根治性颈清扫术。无论肿瘤大小如何，有US可检测转移的患者（US+患者）的无复发生存率（RFS）均显著低于无转移（US-/AP-患者）或AP可检测转移（US-/AP+患者）。肿瘤直径> 2cm的US-/AP+患者RFS较肿瘤直径> 2cm的US-/AP-患者或肿瘤直径为1.1- 2.0cm的US-/AP+患者差。肿瘤尺寸为1.1-2.0 cm的US-/AP+和US-/AP-患者之间的RFS无显著差异。这些发现表明，无论肿瘤大小如何，US可检测的侧向转移预测患者的RFS更差，AP可检测的转移影响肿瘤> 2 cm患者的RFS。
The recent prevalence of ultrasonography has made it easier to detect lymph node metastasis in the lateral compartment of patients with thyroid carcinoma. In this study, we investigated the prognostic impact of lateral node metastasis preoperatively detectable by ultrasonography (US) and metastasis diagnosed by pathology examination but not detected on preoperative US [anatomopathologically (AP)-detectable metastasis] in 560 patients with papillary carcinoma > 1 cm in diameter, who underwent thyroidectomy with modified radical neck dissection at our hospital. Patients with US-detectable metastasis (US+ patients) showed a significantly worse relapse-free survival (RFS) rate than those with no metastasis (US-/AP- patients) or AP-detectable metastasis (US-/AP+ patients) regardless of tumor size. Furthermore, the RFS of US-/AP+ patients with tumors > 2 cur was worse than that of US-/AP-atients with tumors > 2 cm or US-/AP+ patients with tumors measuring 1.1-2.0 cm. There was no significant difference in RFS between US-/AP+ and US-/AP- patients with tumors measuring 1.1-2.0 cm. These findings suggest that US-detectable lateral metastasis predicts a worse RFS for patients regardless of tumor size, and AP-detectable metastasis affects the RFS of patients with tumors > 2 cm.