乳头状微癌
Papillary microcarcinoma.
作者信息
Noguchi Shiro, Yamashita Hiroto, Uchino Shinya, Watanabe Shin
机构信息
Noguchi Thyroid Clinic and Hospital Foundation, Beppu, Japan.
出版信息
World J Surg. 2008 May;32(5):747-53. doi: 10.1007/s00268-007-9453-0.
BACKGROUND
Papillary microcarcinoma (PMC) is increasing in incidence because of diagnosis by ultrasound-guided fine-needle aspiration cytology.
METHODS
Between January 1966 and December 1995, we treated 6019 patients with papillary cancer; among them, 2070 patients with PMC were studied.
RESULTS
PMC is essentially very similar to papillary cancer that is 11 mm or larger and has a very good prognosis. Smaller tumors and younger patients have a better prognosis. Among PMC, larger tumors (6-10 mm) recur in 14% at 35 years compared with 3.3% in patients with smaller tumors. Patients older than 55 years have recurrence in 40% at 30 years, with a worse prognosis than younger patients who have a recurrence rate of less than 10%. Extracapsular invasion by the primary tumor also has a higher recurrence rate. The majority of recurrences are in the neck. Therefore, annual ultrasound of the neck is effective for recurrence surveillance.
CONCLUSION
Papillary microcarcinoma is similar to larger papillary carcinomas with tumor characteristics and age-based recurrence rate that extends for many years, justifying long surveillance after surgery.
背景
由于超声引导下细针穿刺细胞学检查的应用，乳头状微癌（PMC）的发病率正在上升。
方法
1966年1月至1995年12月期间，我们治疗了6019例乳头状癌患者；其中，对2070例PMC患者进行了研究。
结果
PMC本质上与直径11毫米或更大的乳头状癌非常相似，预后非常好。肿瘤较小和年龄较轻的患者预后较好。在PMC中，较大的肿瘤（6 - 10毫米）在35年时的复发率为14%，而较小肿瘤患者的复发率为3.3%。55岁以上的患者在30年时的复发率为40%，预后比复发率低于10%的年轻患者更差。原发肿瘤的包膜外侵犯也有较高的复发率。大多数复发发生在颈部。因此，每年进行颈部超声检查对复发监测有效。
结论
乳头状微癌与较大的乳头状癌相似，具有肿瘤特征和基于年龄的复发率，且这种情况会持续多年，这证明了手术后进行长期监测的合理性。
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