Clinical and pathological characteristics of incidental and nonincidental papillary thyroid microcarcinoma in 339 patients
Clinical and pathological characteristics of incidental and nonincidental papillary thyroid microcarcinoma in 339 patients
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DOI：
10.1002/hed.23333
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发表时间：
2014-04-01
影响因子：
2.9
通讯作者：
Kouraklis, Gregory
中科院分区：
文献类型：
--
作者：
Vasileiadis, Ioannis;Karatzas, Theodore;Kouraklis, Gregory
我们分析了甲状腺肿大高发区甲状腺微小乳头状癌(PTMC)的发病率和临床病理特点，以探讨偶发与非偶发PTMC的差异。乳头状癌583例。在这些患者中，339名PTMC患者被纳入研究。结果在所有接受甲状腺疾病手术的患者中，偶发PTMC的发生率为12%。单因素分析显示，双侧性(p=.001)、自身免疫性甲状腺疾病(p=.049)、肿瘤大小5 mm(p<；.001)、多灶性(p<；.001)、淋巴结转移(p<；.001)和包膜侵犯(p<；.001)与非偶发性PTMC显著相关。偶发性PTMC的淋巴结转移率为5%，而非偶发性PTMC的淋巴转移率为33%，提示两者的生物学行为可能不同。结论PTMC的高发生率存在一个或多个危险因素，包括多灶性、双侧性、包膜侵犯和淋巴结转移。因此，我们建议甲状腺全切除术后充分探查颈部中央间隙，以确定是否有结节受累并切除，这是一种安全的治疗方法。(C)2013 Wiley期刊公司Head Neck36：564-570,2014
BackgroundWe analyzed the incidence and the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) in a high prevalence region of goiter with the purpose to investigate differences between incidental and nonincidental PTMC.MethodsA total of 2236 patients who underwent total thyroidectomy from 2001 to 2009 were reviewed retrospectively. Papillary carcinoma was diagnosed in 583 patients. Of these, 339 patients with PTMC were included in the study. Clinicopathological features were evaluated by univariate and multivariate analysis.ResultsThe prevalence of incidental PTMC was 12% of all patients who underwent surgery for thyroid disease. Univariate analysis showed that bilaterality (p = .001), autoimmune thyroid disease (p = .049), size of tumor >5 mm (p < .001), multifocality (p < .001), lymph node metastasis (p < .001), and capsule invasion (p < .001) were significantly associated with nonincidental PTMC. The incidence of lymph node metastasis in incidental PTMC was 5% versus 33% in nonincidental, suggesting that the biological behavior may be different in the 2 categories.ConclusionOur results indicate that a high rate of PTMC presented 1 or more risk factors including multifocality, bilaterality, capsule invasion, and lymph node metastasis. Therefore, we suggest total thyroidectomy followed by adequate exploration of the central neck compartment for possible nodal involvement and resection as a safe therapeutic approach. (c) 2013 Wiley Periodicals, Inc. Head Neck36: 564-570, 2014