分化型甲狀腺癌預(yù)防性中央組淋巴結(jié)清掃的臨床分析.pdf

1、上海交通大學(xué)博士學(xué)位論文分化型甲狀腺癌預(yù)防性中央組淋巴結(jié)清掃的臨床分析姓名：王清宇申請(qǐng)學(xué)位級(jí)別：博士專(zhuān)業(yè)：臨床醫(yī)學(xué)（普通外科）指導(dǎo)教師：全志偉201104上海交通大學(xué)八年制醫(yī)學(xué)博士學(xué)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