Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Head Neck. 2010 Jan;32(1):38-45. doi: 10.1002/hed.21142.
Papillary thyroid microcarcinoma (PMC; <or=1 cm) is thought to take a benign course during the lifetime. However, recent studies showed high recurrence rates for PMC.
We analyzed the clinicopathological features, long-term prognosis, and some molecular characteristics including BRAF(V600E) mutation by retrospectively reviewing the records of 1150 patients with papillary thyroid carcinoma (PTC), 278 with PMC, and 868 with PTC >1 cm.
The prevalence of extrathyroidal invasion (52.2%) and initial nodal metastasis (34.9%) in patients with PMC was surprisingly high and almost as high as that for patients with PTC (72.4% and 51.8%, respectively). The rate of recurrent or persistent disease did not differ between patients with PMC and PTC (recurrent or persistent disease, 6.1% vs 14.1%; 53.4- vs 84.2-month follow-up; n = 98 vs 647; corrected p = .112). The frequency of BRAF(V600E) mutation was similar in patients with PMC and PTC (65.6% vs 67.2%). Immunohistochemical staining showed no different expression pattern according to the tumor size.
These results suggest that PMC is not an occult cancer and it can act like larger PTC. Therefore, PMC should not be underestimated in practice.
甲状腺微小乳头状癌（PMC；<或=1 厘米）被认为在其一生中具有良性病程。然而，最近的研究显示 PMC 有较高的复发率。
我们通过回顾 1150 例甲状腺乳头状癌（PTC）、278 例 PMC 和 868 例 PTC >1 厘米患者的临床病理特征、长期预后以及一些分子特征，包括 BRAF(V600E)突变，对其进行了回顾性分析。
PMC 患者的甲状腺外侵犯（52.2%）和初始淋巴结转移（34.9%）的发生率高得惊人，几乎与 PTC 患者相同（分别为 72.4%和 51.8%）。PMC 患者和 PTC 患者的疾病复发或持续存在率没有差异（复发或持续存在疾病，6.1%vs.14.1%；53.4-vs.84.2 个月随访；n=98 vs.647；校正后 p=0.112）。PMC 患者和 PTC 患者的 BRAF(V600E)突变频率相似（65.6%vs.67.2%）。免疫组织化学染色显示根据肿瘤大小无不同的表达模式。
这些结果表明，PMC 不是隐匿性癌症，它可以表现得像更大的 PTC。因此，在实践中不应低估 PMC。
