Zhang Wei, Jiao De, Liu Baoguo, Sun Shanping
Department of Breast and Thyroid Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).
Med Sci Monit. 2016 Apr 16;22:1274-9. doi: 10.12659/msm.895564.
BACKGROUND Thyroid cancer is a very common endocrine malignancy, with a rate of total thyroidectomy reported to be up to 27.8%. However, studies analyzing the risk factors that contribute to recurrence of papillary thyroid carcinoma (PTC) after total thyroidectomy in China are still scarce. MATERIAL AND METHODS A total of 536 patients with PTC who underwent total thyroidectomy were retrospectively analyzed. Patients were divided into 2 groups: patients with no recurrent tumor were included in group 1 and patients with tumor recurrence were included in group 2. RESULTS Of 536 patients, 65 patients (12.1%) developed a recurrence of PTC, and 471 patients (87.9%) did not have a recurrence. Univariate analysis indicated that male sex, age ≥50 years, tumor ≥1 cm, poor differentiation, lymph node metastasis, bilaterality, and multifocality may be related to PTC recurrence. Additionally, the results of the logistic regression analysis indicated that male sex, age ≥50 years, primary tumor ≥1 cm, poor dedifferentiation of the tumor, lymph node metastasis, and multifocality may be independent factors contributing to PTC recurrence. CONCLUSIONS Male sex, age more than 50 years, primary tumor larger than 1 cm, poor dedifferentiation of the primary tumor, lymph node metastasis, and multifocality were found to increase the risk of PTC recurrence in patients who underwent total thyroidectomy. Additionally, it is necessary to use strictly aggressive and extensive surgery, as well as close monitoring, after the operation.
背景 甲状腺癌是一种非常常见的内分泌恶性肿瘤，据报道全甲状腺切除术的比例高达27.8%。然而，在中国分析全甲状腺切除术后影响甲状腺乳头状癌（PTC）复发的危险因素的研究仍然很少。
材料与方法 回顾性分析了536例行全甲状腺切除术的PTC患者。患者分为2组：第1组为无肿瘤复发的患者，第2组为有肿瘤复发的患者。
结果 在536例患者中，65例（12.1%）发生PTC复发，471例（87.9%）未复发。单因素分析表明，男性、年龄≥50岁、肿瘤≥1 cm、低分化、淋巴结转移、双侧性和多灶性可能与PTC复发有关。此外，逻辑回归分析结果表明，男性、年龄≥50岁、原发肿瘤≥1 cm、肿瘤低分化、淋巴结转移和多灶性可能是导致PTC复发的独立因素。
结论 发现男性、年龄超过50岁、原发肿瘤大于1 cm、原发肿瘤低分化、淋巴结转移和多灶性会增加行全甲状腺切除术患者PTC复发的风险。此外，术后有必要采用严格积极和广泛的手术以及密切监测。
