Department of Otorhinolaryngology, University Hospital of Parma, 43100 Parma, Italy.
Clin Otolaryngol. 2010 Apr;35(2):118-24. doi: 10.1111/j.1749-4486.2010.02085.x.
To discuss the prognostic factors and outcomes of treatment in patients diagnosed with papillary thyroid microcarcinoma.
Retrospective observational case review.
Department of Otorhinolaryngology of the tertiary referral teaching hospital of Parma.
Ninety-seven patients diagnosed with PTMC and surgically treated between January 1998 and December 2007.
Clinical and histopathological characteristics of the study group were identified and statistically analysed.
No cancer-related deaths were registered. Incidence of recurrent disease was 9% after a 43 month mean follow-up (range 12-120). Univariate analysis detected that metastases in neck lymph nodes at diagnosis (p = 0.025), a tumour >5 mm in size (p = 0.011), the presence of bilateral tumoural foci (p = 0.007), the presence of capsular invasion (p = 0.001), and the presence of vascular invasion (p = 0.004) were related to recurrent disease. On multivariate analysis, the presence of bilateral tumoural foci (p = 0.030), and the presence of capsular invasion (p = 0.005) were significantly related to tumour recurrence.
The prognosis for patients with papillary thyroid microcarcinoma in this series was excellent, with a 100% survival rate and minimal surgical-related morbidity. Nevertheless, approximately 10% of patients developed recurrent disease; aggressive treatment may be justified depending on the presence or absence of prognostic risk factors.
探讨诊断为甲状腺微小乳头状癌患者的预后因素和治疗结果。
回顾性观察性病例回顾。
帕尔马三级转诊教学医院耳鼻喉科。
1998 年 1 月至 2007 年 12 月期间诊断为 PTMC 并接受手术治疗的 97 例患者。
确定并统计分析研究组的临床和组织病理学特征。
未发生与癌症相关的死亡。在平均 43 个月（12-120 个月）的随访后，复发率为 9%。单因素分析发现，诊断时颈部淋巴结转移（p = 0.025）、肿瘤直径>5 毫米（p = 0.011）、双侧肿瘤病灶（p = 0.007）、包膜侵犯（p = 0.001）和血管侵犯（p = 0.004）与疾病复发相关。多因素分析显示，双侧肿瘤病灶（p = 0.030）和包膜侵犯（p = 0.005）与肿瘤复发显著相关。
本系列中甲状腺微小乳头状癌患者的预后良好，存活率为 100%，手术相关发病率低。然而，约 10%的患者出现疾病复发；根据预后危险因素的存在与否，可能需要积极治疗。
