[我们对甲状腺微小乳头状癌的经验]

[Our experience with papillary microcarcinoma of the thyroid].

作者信息

Garrel R, Cartier C, Marvaso V, Corpelet D, Makeieff M, Crampette L, Guerrier B

机构信息

CHU Gui de Chauliac, Service d'ORL et Chirurgie Cervico-Faciale, Rue Augustin Fliche, F-34295 Montpellier, France.

出版信息

Rev Laryngol Otol Rhinol (Bord). 2002;123(4):239-42.

PMID:12723489

Abstract

INTRODUCTION

Papillary microcarcinoma (PMC) of the thyroid gland is high incidence pathology. Most of cases are related to a good prognosis. Conversely, numerous cases are reported with an aggressive course. Prognosis factors are age, size of tumour, multifocality, capsular invasion and cervical lymphadenopathy.

MATERIAL AND METHOD

We have conduced a retrospective study about 4,208 consecutive thyroidectomies over a period of 16 years. 251 cases of papillary cancers were analysed including 64 PMC (25.5%).

RESULTS

90% of PMC were incidentally found and 59% were diagnosed during surgical procedure. Multifocality improved the sensibility of histological diagnosis (P = 0.04). In 78%, total thyroidectomy was performed associated with a selective neck dissection in 47%. In case of extemporaneous diagnosis all partial thyroidectomy was convert into total thyroidectomy. In case of delayed diagnosis and in the absence of unfavourable prognosis factor, no other surgical procedure was carried out. A 7 years mean follow-up revealed only one case of recurrence successfully treated with Iodine 131 ablation. There was no case of death due to PMC.

CONCLUSION

This study confirms the good prognosis of PMC treated according to usual criterions.

摘要

引言

甲状腺乳头状微小癌（PMC）是一种高发性病理类型。大多数病例预后良好。相反，也有许多病例报告显示病情呈侵袭性发展。预后因素包括年龄、肿瘤大小、多灶性、包膜侵犯和颈部淋巴结病。

材料与方法

我们对16年间连续进行的4208例甲状腺切除术进行了回顾性研究。分析了251例乳头状癌病例，其中包括64例PMC（25.5%）。

结果

90%的PMC是偶然发现的，59%是在手术过程中确诊的。多灶性提高了组织学诊断的敏感性（P = 0.04）。78%的患者实施了全甲状腺切除术，47%的患者同时进行了选择性颈部清扫术。如果是术中临时诊断，所有的部分甲状腺切除术都会转为全甲状腺切除术。如果是延迟诊断且不存在不良预后因素，则不进行其他手术操作。平均7年的随访显示，只有1例复发患者通过碘131消融成功治疗。没有因PMC导致死亡的病例。