摘要目的 通过检测环氧化酶-2(COX-2)在人甲状腺乳头状癌(PTC)颈部淋巴结中的表达,评价中央区(Ⅵ区)淋巴结清扫在颈侧区、颈侧后区(Ⅱ-Ⅴ区)淋巴结阴性(cNO)的PTC中价值.方法 应用免疫组织化学SP法埘49例临床cNO行功能性颈淋巴结清扫术的PTC患者检测Ⅵ区、Ⅱ-Ⅴ区淋巴结COX-2的表达.结果 Ⅵ区淋巴结转移10例(20%),COX-2阳性9例(90%);Ⅱ-Ⅴ区转移6例(12%),COX-2阳性5例(83%);Ⅵ区淋巴结转移者中Ⅱ-Ⅴ区转移率为50%(5/10),Ⅵ区未转移者中Ⅱ-Ⅴ区转移率15%(1/39),两组差异有统计学意义(P<0.05);淋巴结未转移者COX-2阳性率Ⅵ区占15%,Ⅱ-Ⅴ区20%.结论 COX-2的表达与甲状腺乳头状癌浸润程度、淋巴结转移密切相关,将Ⅵ区淋巴结与Ⅱ-Ⅴ区淋巴结明确区分对临床治疗具有指导价值,对于cNO的PTC患者应常规行Ⅵ区淋巴结清扫术.

abstractsObjective To evaluate the value of region Ⅵ lymph nodes in surgical treatment of oN0 pa-pillary thyroid carcinoma(PTC) by stoding the expression of COX-2 in lymph nodes. Methods 49 cases of PTC with cN0 which received functional lymph nodes dissection were collected, Immunhistochemical S-P method was employed to detect the expression of COX-2 by region Ⅵ lymph nodes distinguished from lateral neck lymph nodes(Ⅱ -Ⅴ). Results In 49 cases, the rate of region Ⅵ lymph nodes metastasis was 20% , COX-2 was 90% ; the rate of region Ⅱ -Ⅴ lymph nodes metastasis was 12% , COX-2 was 15%. In cases with region Ⅵ lymph nodes metastasis, the rate of Ⅱ- Ⅴ lymph nodes metastasis was 50%. Meanwhile in cases without region Ⅵ lymph nodes metastasis,the rate of Ⅱ-Ⅴ lymph nodes metastasis was 15%. Conclusion The expression of COX-2 related to the degree of infihrat ion and lymph node metastasis in PTC. It is necessary that region Ⅵ lymph nodes distinguished from Ⅱ -Ⅴ lymph nodes. To dissect and have pathological examination of the region Ⅵ lymph nodes during the operation is important for patients of PTC with cNO.