Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan.
Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan.
Int J Endocrinol. 2013;2013:809382. doi: 10.1155/2013/809382. Epub 2013 Dec 30.
This study was to investigate the clinical features and therapeutic outcomes of multifocal papillary thyroid microcarcinoma (PTMC). A total of 2,418 papillary thyroid carcinoma (PTC) patients had undergone thyroidectomy in one medical center between 1977 and 2010. There were 483 (20.0%) diagnosed with multifocal PTC. The percentage of multifocal PTC was higher in PTMC patients (22.0%) than in non-PTMC patients (19.5%). Demographic and clinical characteristics of PTMC and multifocal PTC in PTC patients were traced. Multifocal PTC patients presented with smaller tumors at an older age, and a higher percentage underwent total or complete thyroidectomy. These patients also showed a higher incidence of postoperative disease progression than did unifocal PTC patients. Comparison of 483 patients with multifocal PTMC and non-PTMC tumors showed a higher incidence of postoperative disease progression in patients with non-PTMC; otherwise, there was no statistical difference in disease-specific and total mortality between these two groups. In conclusion, the incidence of multifocal PTMC was not lower than that of non-PTMC, and postoperative therapies were necessary for both multifocal PTMC and non-PTMC patients.
这项研究旨在探讨多灶性甲状腺微小乳头状癌(PTMC)的临床特征和治疗效果。在 1977 年至 2010 年间,一家医疗中心对 2418 例甲状腺癌(PTC)患者进行了甲状腺切除术。其中 483 例(20.0%)被诊断为多灶性 PTC。PTMC 患者中多灶性 PTC 的比例(22.0%)高于非 PTMC 患者(19.5%)。对 PTC 患者中 PTMC 和多灶性 PTC 的人口统计学和临床特征进行了追踪。多灶性 PTC 患者的肿瘤较小,年龄较大,且更多地接受了全甲状腺或近全甲状腺切除术。这些患者术后疾病进展的发生率也高于单灶性 PTC 患者。与非多灶性 PTMC 肿瘤的 483 例患者相比,多灶性 PTMC 患者术后疾病进展的发生率更高;否则,两组患者的疾病特异性死亡率和总死亡率之间无统计学差异。总之,多灶性 PTMC 的发生率并不低于非多灶性 PTC,多灶性 PTMC 和非多灶性 PTC 患者均需要术后治疗。