| Objective: To investigate the characteristics of papillary thyroid carcinoma withcervical lymph node metastases, the relationship between the diameter of the primarytumor, cervical lymph node metastasis with the prognosis by analyzing the clinical dataof thyroid papillary cancer patients.Methods:899papillary thyroid carcinoma patients treated in the department ofGeneral Surgery at the First Affiliated Hospital of Dalian Medical University fromJanuary2005to December2008were collected. There were556cases without cervicallymph node metastasis,343cases with cervical lymph node metastasis.200cases weremale,699cases were female. The patients aged from14to80years old, median agewas47±2.5years old. All patients were analyzed by age and gender on the recurrencerate of papillary thyroid carcinoma use Chi-square test. According primary tumordiameter, all enrolled patients were divided into three groups:≤1cm,1～2cm and≥2cm. According to with or without lymph node metastasis, all enrolled patients weredivided into two groups: with cervical lymph node metastasis and without lymph nodemetastasis. According to the different areas of lymph node metastasis, all enrolledpatients were divided into two groups: only group Ⅵ metastasized, the groupⅥ andside neck lymph node metastasized. Results:1. The recurrence rate: There were104recurred cases5years after operation,recurrence rate was11.57%. There were740cases without recurrence,82.31%accounton total number. The missing cases were55patients,6.12%account on total number.2. The influence of age on the recurrence rate：There were472cases in≥45yearsgroup, the recurrence rate was11.44%(54/472); there were372cases in <45agegroup, the recurrence rate was13.44%(50/372). The difference between these twogroups was not statistically significant.(P＞0.05).3.The influence of gender on the recurrence rate: There was665cases in femalegroup, the recurrence rate was10.98%(73/665); there were179cases in male group,the recurrence rate was17.31%(31/179), The difference between these two groupswas not statistically significant (P＞0.05).4.The influence of the primary tumor diameter on lymph node metastasis: Therewere371cases in tumor diameter≤1cm group, cervical lymph node metastasis ratewas24.25%(91/371); there were330cases in tumor diameter1～2cm group,cervical lymph node metastasis rate was49.09%(163/330); there were143cases intumor diameter≥2cm group, cervical lymph node metastasis rate was55.94%(81/143).The difference between these two groups was statistically significant.(P＜0.05).5.The influence of the primary tumor diameter on prognostic: There were371cases in tumor diameter≤1cm group, recurrence rate was6.47%(24/371); there were330cases in tumor diameter1～2cm group, recurrence rate was16.67%(55/330); therewere143cases in tumor diameter≥2cm group, recurrence rate was17.48%(25/143).The difference between these two groups was statistically significant (P <0.05). Intumor diameter≤1cm group,5-year survival rate was100%; in tumor diameter1～2cmgroup,5-year survival rate was99.39%; in tumor diameter≥2cm group,5-yearsurvival rate was97.90%. The difference between these two groups was statisticallysignificant (P <0.05).6. The influence of with or without cervical lymph node metastasis on prognosis:There were335cases papillary thyroid carcinoma with cervical lymph node metastasisgroup, which the recurrence rate was19.7%(66/335). There were509cases without cervical lymph node metastasis group, which the recurrence rate was7.47%（38/509）.The difference between these two groups was statistically significant (P <0.05). Ingroup with cervical lymph node metastasis，5-year survival rate was98.51%. In groupwithout none cervical lymph node metastasis,5-year survival rate was100%. Thedifference between these two groups was statistically significant (P>0.05).7. The influence of different lymph node metastasis regions on prognosis: Therewere192cases in group only Ⅵ lymph node metastasis，which the recurrence rate was16.15%(31/192). There were126cases in group Ⅵ and side cervical lymph nodemetastasis, which the recurrence rate was27.78%(35/126). There were17cases in onlyside cervical lymph node metastasis,1.89%account on the total number of cases. Dueto the small number, we did not analyzed them. In group only with Ⅵ group lymphnode metastasis,5-year survival rate was99.52%.In group of Ⅵ group lymph nodemetastasis and side neck lymph node metastasis,5-year survival rate was96.83%, Thedifference between these two groups was statistically significant (P <0.05).Conclusion:1. The characteristics of papillary thyroid carcinoma cervical lymph nodemetastases was mainly transfers to the central group, secondly to the central group andthe side neck area, finally to the side neck area only.2. Age and gender do not influence the recurrence rate of papillary thyroidcarcinoma.3. With the increase of the papillary thyroid carcinoma diameter, the likelihood ofcervical lymph node metastasis was higher, the5-year survival rate was lower.4. The recurrence rate of papillary thyroid carcinoma patients with lymph nodemetastasis was higher than that of without cervical lymph node metastasis, but the5-year survival rate was no different between these two groups.5. The recurrence rate of papillary thyroid carcinoma patients with the group Ⅵand the side neck region lymph node metastasis was higher than that of patients withonly group Ⅵ lymph node metastasis. The5-year survival rate of papillary thyroid carcinoma patients with the group Ⅵ and the side neck region lymph node metastasiswas lower than that of patients with only group Ⅵ lymph node metastasis. |
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