Characteristics, diagnosis, and treatment of lateral cervical lymph node metastasis in differentiated thyroid cancer
Xu Meng, Wang Xiaolei
Department of Head and Neck Surgery, National Cancer Center, National Clinical Research Center for Cance, Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract:Objective This work aims to summarize the characteristics and progress of the diagnosis and treatment of lateral cervical lymph node metastasis in differentiated thyroid cancer (DTC).Methods “分化型甲状腺癌”“淋巴结转移”“侧颈淋巴结转移”“颈淋巴结清扫术”“侧颈淋巴结清扫术”“differentiated thyroid cancer” “cervical lymph node metastasis” “lateral cervical lymph node metastasis” “neck dissection” and “lateral neck dissection” were used as keywords to identify articles about differentiated thyroid carcinoma with lateral cervical lymph node metastasis, as well as its progress of diagnosis and treatment. The articles searched included those published before December 2019 in CNKI, Wanfang, and PubMed. A total of 2 084 articles were retrieved, among which 39 were included after excluding those with inaccessible full text, inconsistent content, redundant topics, and low-quality literatures.Results Lateral cervical lymph node metastasis is common in DTC; the most common metastasis is in levels Ⅲ and Ⅳ, and relatively rare ones are in levels Ⅰ, Ⅱ, and Ⅴ. Ultrasound is the preferred choice for imaging diagnosis, and enhanced CT and MRI are used as supplementary examinations. Preoperative qualitative diagnosis depends on fine-needle aspiration biopsy. In recent years, surgery as the preferred choice of treatment has been refined. At present, for patients with DTC (cN1b), therapeutic lateral neck dissection has basically reached a consensus. Chemotherapy, radiotherapy, and biotherapy are used as adjuvant treatment for advanced patients.Conclusions Comprehensive preoperative evaluation, accurate intraoperative location, appropriate dissection, and adjuvant treatment are the optimal strategies for patients with lateral cervical lymph node metastasis in DTC.
徐萌, 王晓雷. 分化型甲状腺癌侧颈部淋巴结转移特点及诊疗技术研究进展[J]. 中华解剖与临床杂志, 2021, 26(3): 362-367.
Xu Meng, Wang Xiaolei. Characteristics, diagnosis, and treatment of lateral cervical lymph node metastasis in differentiated thyroid cancer. Chinese Journal of Anatomy and Clinics, 2021, 26(3): 362-367.
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