Cho Jin-Kyu, Kim Ju-Yeon, Jeong Chi-Young, Jung Eun-Jung, Park Soon-Tae, Jeong Sang-Ho, Ju Young-Tae, Lee Young-Joon, Hong Soon-Chan, Ha Woo-Song, Choi Sang-Kyung
Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea.
J Korean Surg Soc. 2012 May;82(5):281-7. doi: 10.4174/jkss.2012.82.5.281. Epub 2012 Apr 26.
Clinical outcomes of papillary thyroid microcarcinoma (PTMC) vary. In general, age at diagnosis is an independent prognostic factor in conventional papillary thyroid carcinoma. However, it is unclear in patients of PTMC. The purpose of this study was to identify clinicopathologic features and prognostic factors of PTMC according to patients' age.
Five hundred twenty-seven patients who received thyroid surgery and diagnosed as having PTC between January 2001 and December 2009 were included. The clinical data were retrospectively analyzed.
We divided the patients into two groups; group I who were younger than 45 years, and group II who were 45 years old or older. The mean tumor size and incidences of neck lymph nodes involvement of group I was larger than group II. In group II, however, there were more patients who had multiple cancer foci and were body mass index ≥ 25 kg/m(2). The overall incidence of recurrent disease was 3.2%. The incidence of recurrence was higher in group II (2.0% vs. 4.0%), without a statistical difference. In multivariate analysis, the significant risk factors of recurrence were male gender and multifocality in group I, and lymph node metastasis and multifocality in group II. In particular, the male gender and multifocality showed the highest odds ratio (OR) on each group (OR, 4.721 and 6.177).
The patients with PTMCs had different clinical features and prognostic factors according to age. Hence, clinicians should consider a different strategy for therapy and plan for follow-up according to age.
甲状腺微小乳头状癌（PTMC）的临床结局各不相同。一般来说，诊断时的年龄是传统甲状腺乳头状癌的独立预后因素。然而，在PTMC患者中尚不清楚。本研究的目的是根据患者年龄确定PTMC的临床病理特征和预后因素。
纳入2001年1月至2009年12月期间接受甲状腺手术并诊断为PTC的527例患者。对临床资料进行回顾性分析。
我们将患者分为两组；I组年龄小于45岁，II组年龄为45岁或以上。I组的平均肿瘤大小和颈部淋巴结受累发生率高于II组。然而，在II组中，有更多患者有多个癌灶且体重指数≥25kg/m²。疾病复发的总体发生率为3.2%。II组的复发率较高（2.0%对4.0%），但无统计学差异。在多变量分析中，I组复发的显著危险因素是男性和多灶性，II组是淋巴结转移和多灶性。特别是，男性和多灶性在每组中显示出最高的比值比（OR）（OR分别为4.721和6.177）。
PTMC患者根据年龄有不同的临床特征和预后因素。因此，临床医生应根据年龄考虑不同的治疗策略和随访计划。
