갑상선유두암종의 측경부 림프절 전이 인자 분석 = Analysis of Influencing Factors on Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Cancer

다국어 초록 (Multilingual Abstract)

Background and Objectives: The aim of this study was to evaluate the incidence and risk factors of lateral cervical lymph node metastasis in papillary thyroid carcinoma (PTC). Materials and Methods: A retrospective review of the 47 patients who were diagnosed as PTC and initially treated by total thyroidectomy, central and lateral neck dissection was performed from January 2000 to July 2009. Twenty-nine patients had simultaneous unilateral lateral neck dissection, while 18 had bilateral lateral neck dissection. Results: The median age was 52.3 years (range, 19∼80 years); there were 13 males and 34 females. The rate of ipsilateral cervical lymph node metastasis was 91.5% (43 out of 47). Contralateral cervical lymph node metastasis was present in 12 out of the 18 cases (66.7%). The most frequent sites for ipsilateral positive neck nodes were level IV (74.4%), level III (65.1%), level II (51.2%), level V (23.3%), and level I (2.3%). Contralateral positive lymph nodes were found in level IV (50%), levels II (50%), and level III (41.6%). There was a significant correlation of lateral lymph node metastasis with primary tumor size (more than 2 cm) (p＜0.001), lymphatic invasion (p＜0.001), capsular invasion (p=0.032), muscle invasion (p＜0.001), and level VI metastasis (p＜0.001). The multivariate analysis showed that primary tumor size, lymphatic invasion and muscle invasion were significantly correlated with cervical lymph node metastasis (p=0.006, p=0.028 and p=0.007, respectively). Conclusion: In our series, lateral cervical metastases from PTC were commonly present at level IV, III, and II. Large primary tumor size, lymphatic invasion and muscle invasion are associated with lateral cervical lymph node metastasis.