分化型甲狀腺癌預防性中央組淋巴結清掃的臨床分析.pdf

1、上海交通大學博士學位論文分化型甲狀腺癌預防性中央組淋巴結清掃的臨床分析姓名：王清宇申請學位級別：博士專業(yè)：臨床醫(yī)學（普通外科）指導教師：全志偉201104上海交通大學八年制醫(yī)學博士學位論文AbstractBackground：Thyroidcanceristhemostcommonendocrinemalignancyinthepastfewdecades；theincidenceratehadbeenincreasedWhichdif

2、ferentiatedthyroidcanceraccountedforincidencerateofthyroidcancermorethan90％Despitethegoodprognosisofdifferentiatedthyroidcancerandthehighsurvivalrate，moredatashowedthatpatients’cervicallymphnodemetastasisrelatedtolongter

3、msurvival，diseasefreesurvivalandotherprognosticindicatorsHasbeenprovedthatdifferentiatedthyroidcarcinoma(especiallypapillarycarcinoma)inpatientsaccompaniedbycervicallymphnodemetastasisisverycommon，andthecentrallymphnodem

4、etastasisthemosthappenedAtpresentclinicalpositivenecklymphnodes(cN)patientsperformingroutineneckdissectionhasbeenaconsensus，butnecklymphnodedissectiontotheclinicalnegativenecklymphnodes(cN0)inpatientswitlldifferentiatedt

5、hyroidcarcinomaisstillbeendiscussed，alsotherangeandindicationsisstillhotlydebatedamongdomesticandforeignphysicians，forthereiSnoclearconclusionyetMethods：RetrospectiveanalysisdataofShanghaiJiaoTongUniversityAffiliatedXinh

6、uaHospitalandRenjiHospitalofGeneralSurgeryfromJanuary2008toDecember2010，whichthepatientsdiagnosedwithoN0differentiatedthyroidcancerwerecomparedUnivariateandmultivariateanalysisaleappliedtevealthefactorsthatdeterminetheme

7、tastasisofcentrallymphnodes，andthustodiscussthenecessityofprophylacticcentrallymphnodedissectionResults：IncNOpatientswithdifferentiatedthyroidcancerthecentrallymphnodemetastasisratewas441％Tumorsize，thenumberoflymphnodeth

8、atobtainedbysurgeryareindependentpredictorsoflymphnodemetastasis，andthebiggerthetumorbecame，orthemorelymphnodesobtainedbysurgerythegreatertheprobabilityofcentrallymphnodemetastasis；genderageofdiagnosis，age(grouped)，tumor