Lee Junho, Rhee Yumie, Lee Sihoon, Ahn Chul Woo, Cha Bong Soo, Kim Kyung Rae, Lee Hyun Chul, Kim Seung Il, Park Cheong Soo, Lim Sung-Kil
Department of Internal Medicine & Endocrine Research Institute, Yonsei University College of Medicine, Shinchon-dong, Seoul, South Korea.
Endocr J. 2006 Oct;53(5):627-32. doi: 10.1507/endocrj.k06-013. Epub 2006 Aug 8.
The incidence of thyroid microcarcinoma is rising due to the frequent use and improvement of fine-needle aspiration biopsy and ultrasonography. Since the recent update of the TNM (Tumor, Node, Metastasis) staging system for thyroid cancer, the importance of lymph node metastasis became more prominent. In the present study, we evaluated the prognostic factors and extension of thyroid microcarcinomas in Korean patients. The clinical and pathological findings in patients with thyroid microcarcinomas in a Korean hospital from January through December 2004 were evaluated. A total of 302 (50.2%) out of 601 cases of thyroid cancers were microcarcinomas. Evaluation of the histology revealed that nearly all of the cases (300 of 302) were of the papillary type. Analyzing patients of papillary thyroid microcarcinomas, 273 (91.0%) out of 300 patients of papillary microcarcinomas were women. Seventy-eight (26.0%) cases contained multiple tumor masses (> or =2), including 49 (16.3%) cases that were bilateral. There were 84 (28.0%) cases of extrathyroidal extensions and 89 cases (29.7%) of lymph node metastasis, but no cases of distant metastases. Application of the new staging system revealed 7 (2.3%) cases that changed from stage III to stage IVA. Thyroid microcarcinomas were also associated with poor prognostic factors and appear to exist at relatively higher cancer stages. Therefore, it is important to treat them as early and as vigorously as possible with extensive surgery, radioactive iodine therapy, and thyroxine suppression.
由于细针穿刺活检和超声检查的频繁使用及技术改进，甲状腺微小癌的发病率正在上升。自甲状腺癌的TNM（肿瘤、淋巴结、转移）分期系统最近更新以来，淋巴结转移的重要性变得更加突出。在本研究中，我们评估了韩国患者甲状腺微小癌的预后因素和病变范围。对一家韩国医院2004年1月至12月期间甲状腺微小癌患者的临床和病理结果进行了评估。601例甲状腺癌病例中，共有302例（50.2%）为微小癌。组织学评估显示，几乎所有病例（302例中的300例）为乳头状类型。在分析乳头状甲状腺微小癌患者时，300例乳头状微小癌患者中有273例（91.0%）为女性。78例（26.0%）病例包含多个肿瘤灶（≥2个），其中49例（16.3%）为双侧。有84例（28.0%）出现甲状腺外侵犯，89例（29.7%）出现淋巴结转移，但无远处转移病例。应用新的分期系统显示，有7例（2.3%）病例从III期变为IVA期。甲状腺微小癌还与不良预后因素相关，且似乎处于相对较高的癌症分期。因此，尽早并积极地采用广泛手术、放射性碘治疗和甲状腺素抑制治疗非常重要。
