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254例甲状腺微小乳头状癌的临床病理分析

[Clinicopathologic analysis of 254 cases of papillary thyroid microcarcinoma].

作者信息

Fu Xiaodan, Lou Shanxian, Shi Hongqi, Liu Qingwei, Chen Zhenwei, Zhou Yibo

机构信息

Department of Pathology, Jinhua Municipal Central Hospital, Zhejiang 321000, China.

E-mail:

出版信息

Zhonghua Bing Li Xue Za Zhi. 2015 Apr;44(4):258-61.

Abstract

OBJECTIVE

To evaluate the prognostic impact of tumor size, ultrasonography, central neck lymph node involvement, and age of patients in papillary thyroid microcarcinoma (PTMC).

METHODS

Two hundred and fifty-four patients who underwent total thyroidectomy and central neck dissection for PTMC between 2012 and 2014 were included in this retrospective study. Statistical correlation between tumor size and various clinicopathological parameters was assessed by univariate and multivariate analyses. The ultrasound findings were also evaluated.

RESULTS

A total of 254 patients (199 females and 55 males) were included in this study. PTMC showed a predilection for female patients, 41-50 years of age (43.3% of all cases, 110/254), and ultrasound showed hypoechoic nodules. Statistically significant correlation was demonstrated between central neck lymph node involvement and the following factors: age and tumor size. A tumor diameter greater than 0.5 mm (67.3% of all cases) most commonly occurred in patients older than 41 years, and was associated with a higher risk of metastatic central neck lymph node involvement (P<0.05). Hashimoto's thyroiditis was noted in the background in 39.4%(100/254) of cases.

CONCLUSIONS

Tumor size appears to have a prognostic impact in PTMC, and larger size is more likely to be associated with a higher risk of central neck lymph node involvement. It is controversial whether the etiology of papillary thyroid carcinoma is related to Hashimoto's thyroiditis.

摘要

目的

评估肿瘤大小、超声检查、中央区颈部淋巴结受累情况及患者年龄对甲状腺微小乳头状癌(PTMC)预后的影响。

方法

本回顾性研究纳入了2012年至2014年间因PTMC接受甲状腺全切除术及中央区颈部淋巴结清扫术的254例患者。通过单因素和多因素分析评估肿瘤大小与各种临床病理参数之间的统计学相关性。同时对超声检查结果进行评估。

结果

本研究共纳入254例患者(199例女性,55例男性)。PTMC好发于41至50岁的女性患者(占所有病例的43.3%,110/254),超声表现为低回声结节。中央区颈部淋巴结受累与以下因素之间存在统计学显著相关性:年龄和肿瘤大小。肿瘤直径大于0.5mm(占所有病例的67.3%)最常见于41岁以上的患者,且与中央区颈部淋巴结转移风险较高相关(P<0.05)。39.4%(100/254)的病例背景中存在桥本甲状腺炎。

结论

肿瘤大小似乎对PTMC的预后有影响,较大的肿瘤更有可能与中央区颈部淋巴结受累的较高风险相关。甲状腺乳头状癌的病因是否与桥本甲状腺炎有关存在争议。

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