Kim Dong Wook
a Department of Radiology , Busan Paik Hospital, Inje University College of Medicine , Busan , South Korea.
Endocr Res. 2016 Aug;41(3):213-7. doi: 10.3109/07435800.2015.1137583. Epub 2016 Feb 11.
This study aimed to assess the prevalence of tumor recurrence and to determine the appropriate interval of follow-up ultrasonography (US) in papillary thyroid microcarcinoma (PTMC) patients who underwent lobectomy.
Between January and December 2006, 137 patients underwent a lobectomy for the treatment of PTMC and at least one postoperative US follow-up examination. The postoperative follow-up US was performed by a single radiologist for all patients. Based on the follow-up US and histopathological results, tumor recurrence and nodal metastasis were determined.
In the 137 patients, the following diagnoses were made after lobectomy: intraglandular PTMC (n = 104), focally perithyroidal PTMC invasion within surgical margins (n = 18), nodal metastasis to the ipsilateral level VI node (n = 20), and satellite PTMC (n = 7). The patients showed differences in the number of post-operative follow-up US sessions and in the intervals of those sessions. Of the 137 patients, 135 (98.5%) exhibited no tumor recurrence on the follow-up US, whereas 2 (1.5%) exhibited tumor recurrence in the remnant thyroid gland. In these two patients with tumor recurrence, suspicious thyroid nodules were detected at the 96- and 90-month follow-up US, respectively.
In this study, the PTMC tumor recurrence rate was low, indicating that early post-lobectomy follow-up US in short intervals is not beneficial for detecting PTMC recurrence.
本研究旨在评估甲状腺乳头状微小癌(PTMC)患者行肺叶切除术后肿瘤复发的发生率,并确定合适的超声(US)随访间隔时间。
2006年1月至12月期间,137例患者因PTMC接受了肺叶切除术,并至少接受了一次术后US随访检查。所有患者的术后随访US均由一名放射科医生进行。根据随访US和组织病理学结果,确定肿瘤复发和淋巴结转移情况。
137例患者肺叶切除术后的诊断如下:腺内PTMC(n = 104)、手术切缘内局灶性甲状腺周围PTMC侵犯(n = 18)、同侧Ⅵ区淋巴结转移(n = 20)和卫星PTMC(n = 7)。患者在术后随访US检查的次数和检查间隔方面存在差异。137例患者中,135例(98.5%)在随访US中未出现肿瘤复发,而2例(1.5%)在残余甲状腺中出现肿瘤复发。在这2例肿瘤复发患者中,分别在96个月和90个月的随访US中检测到可疑甲状腺结节。
在本研究中,PTMC肿瘤复发率较低,表明肺叶切除术后短期内进行早期随访US对检测PTMC复发并无益处。