ObjectiveTo study the regularity of cervical lymph node metastasis in papillary thyroid carcinoma and a reasonable surgical method. MethodsThe clinical data of 221 cases of papillary thyroid carcinoma treated in this hospital between September 2004 and September 2009 were analyzed retrospectively. ResultsThere were 32 cases treated with total thyroidectomy, 189 patients with subtotal thyroidectomy. Two hundred and two patients with unilateral thyroid carcinoma and 19 patients with bilateral thyroid carcinoma were diagnosed by pathology. The diameter of tumor was 0.2-8.0 cm with an average of 3.5 cm. The amicula invasion was found in 50 cases and mulifocality in 33 cases. The numbers of lymph node dissection were 10-24 with an average of 14.3 in unilateral. The total lymph node metastasis rate was 37.56% (83/221), the lymph node metastasis rate was 33.94% (75/221) in the Ⅵ region, and which was 18.10% (40/221) in the Ⅱ+Ⅲ+Ⅳ region. The rate of cervical lymph node metastasis markedly increased in the patients with the primary tumor diameter gt;1.0 cm, amicula invasion, multifocality, or age gt;45 years in the Ⅵ region and ipsilateral of Ⅱ+Ⅲ+Ⅳ region (Plt;0.05). ConclusionsIn patients with thyroid papillary carcinoma, the most common lymph node metastasis happened in the Ⅵ region, next in the Ⅱ+Ⅲ+Ⅳ region. Lymph nodes of the Ⅵ region should routinely be dissected in the first surgery, the lymph nodes of the Ⅱ+Ⅲ+Ⅳ region should be dissected when the tumor diameter gt;1.0 cm, amicula invasion, multifocality or ultrasonic, CT, and other imaging examinations demonstrated cervical lymph node metastasis.
ObjectiveTo systematically review the efficacy and safety of 89SrCl2 for bone metastases.MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 12, 2016), MEDLINE, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to December 2016 to collect randomized controlled trials (RCT) about 89SrCl2 in the treatment of bone metastases. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 19 RCTs involving 1 899 patients were included. The results of meta-analysis showed that: compared to the group without 89SrCl2, group of 89SrCl2 combined with other treatments had benefits for complete relief of bone pain (RR=1.53, 95%CI 1.16 to 2.01, P=0.002), total relief of bone pain (RR=1.33, 95%CI 1.22 to 1.45, P<0.001), bone metastases complete response rate (RR=1.61, 95%CI 1.20 to 2.16, P=0.002), bone metastases total response rate (RR=1.61, 95%CI 1.26 to 2.08, P<0.001), improvement of quality of life (RR=1.44, 95%CI 1.06 to 1.97, P=0.02). The proportion of pain flare (RR=10.35, 95%CI 2.01 to 53.37, P=0.005), leucopenia (RR=2.49, 95%CI 1.84 to 3.37, P<0.001) and thrombocytopenia (RR=2.64, 95%CI 1.76 to 3.97, P<0.001) in the 89SrCl2 group were higher than that in the control group.Conclusion89SrCl2 combined with the other treatments is better for bone metastases than without 89SrCl2. Due to the limited quantity and quality of included studies, the above results should be verify by more high quality studies.