Gülben Kaptan, Berberoğlu Uğur, Celen Orhan, Mersin Hüsnü H
Langenbecks Arch Surg. 2008 Jan;393(1):25-9. doi: 10.1007/s00423-007-0213-2. Epub 2007 Aug 10.
Despite the overall excellent prognosis for patients with thyroid papillary microcarcinoma (PMC), these tumors are associated with lymph node metastasis. The aim of this study is to identify the rate of lymph node metastasis and evaluate the clinical and pathological factors affecting metastasis in thyroid PMC.
Among 475 patients with papillary thyroid carcinoma treated between 1990 and 2003, 81 patients (17%) were diagnosed as PMC and the records of these patients were evaluated retrospectively. Clinicopathologic features were evaluated by univariate and multivariate analyses.
According to age, metastases, extent, and size risk definition, all patients were in low-risk group. Lymph node metastases were determined in 12.3% of patients. Mean follow-up was 7 years (range from 28 to 192 months). Ten-year disease-free and overall survival rates were 97 and 100%, respectively. Both multifocality and thyroid capsular invasion were found to be independent risk factors for lymph node metastasis by multivariate analysis.
Patients with thyroid PMC in low-risk group with multifocal tumors and with capsule invasion may have increased risk of lymph node metastasis, and must be considered in follow-up of the patients who have these factors.
尽管甲状腺微小乳头状癌（PMC）患者的总体预后良好，但这些肿瘤与淋巴结转移相关。本研究的目的是确定甲状腺PMC的淋巴结转移率，并评估影响转移的临床和病理因素。
在1990年至2003年间接受治疗的475例甲状腺乳头状癌患者中，81例（17%）被诊断为PMC，对这些患者的记录进行回顾性评估。通过单因素和多因素分析评估临床病理特征。
根据年龄、转移情况、范围和大小风险定义，所有患者均处于低风险组。12.3%的患者存在淋巴结转移。平均随访7年（范围为28至192个月）。10年无病生存率和总生存率分别为97%和100%。多因素分析发现多灶性和甲状腺包膜侵犯均为淋巴结转移的独立危险因素。
具有多灶性肿瘤和包膜侵犯的低风险组甲状腺PMC患者可能有更高的淋巴结转移风险，在对有这些因素的患者进行随访时必须予以考虑。
