Analyiss of lymph nodes metastasis in papillary thyroid carcinoma and its surgical approaches

Objective To investigate the characteristics of lymph nodes metastasis in papillary thyroid carcinoma (PTC) and to discuss surgical approach.Methods All patients underwent total thyroidectomy,central lymph nodes and lateral lymph nodes dissection in Department of Thyroid Surgery,the First Hospital of the Jilin University,from Dec.2011 to Dec.2012.Results With the increase of the number of positive central lymph nodes,lateral cervical lymph node metastasis rate increased as well and accompanied multi region metastasis trend.In 102 cases of lateral positive cervical lymph node patients,55 cases were in level Ⅱ,accounting for 53.92％,62 cases were in level Ⅲ,accounting for 60.78％,76 cases were in level Ⅳ,accounting for 74.51％,and 17 cases were in level V,accounting for 16.67％.In lateral lymph nodes metastasis,we found level Ⅳ was the most vulnerable area,followed by level Ⅲ,level Ⅱ and level Ⅴ.Conclusions Prophylactic central lymph node dissection should be performed in PTC patients.Patients with central lymph node metastasis especially with the number of positive lymph nodes ＞ 3 should be performed ipsilateral level Ⅱ-Ⅴ lymph node dissection. Key words: Papillary thyroid carcinoma;  Lymph node metastasis;  Neck dissection