Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
Oral Oncol. 2017 Sep;72:183-187. doi: 10.1016/j.oraloncology.2017.02.008. Epub 2017 Feb 20.
Extrathyroidal extension (ETE) is a poor prognostic factor in papillary thyroid carcinoma (PTC). However, the impact of the degree of ETE, especially microscopic ETE, has not been well established. The purpose of present study was to compare differences in clinicopathological characteristics and clinical outcomes according to the presence or extent of ETE.
Data from 381 patients who underwent total thyroidectomy with/without lymph node (LN) dissection for PTC between 2004 and 2010 were analyzed. Clinicopathological features such as age, gender, LN metastasis, capsular invasion, lymphovascular invasion, and recurrence were compared among three groups divided according to degree of ETE: no ETE (n=144), microscopic ETE (n=191), and macroscopic ETE (n=46).
Tumor size, LN metastasis, lymphovascular invasion, extent of surgery, and administration of postoperative radioactive iodine (RAI) were significantly correlated with degree of ETE. Especially, among the patients with a primary tumor size ≤4cm, the patients with microscopic ETE showed more LN metastasis and lymphovascular invasion than those without ETE, whereas less LN metastasis and lymphovascular invasion than those with macroscopic ETE. In addition, the microscopic ETE group had a significantly lower 5-year recurrence free survival (RFS) than the no-ETE group (92.1% vs. 99.3%, p<0.001) and a significantly higher 5-year RFS than the macroscopic ETE group (92.1% vs. 65.2%, p<0.001).
The degree of ETE is correlated with clinicopathologic features and tumor recurrence. Patients with microscopic ETE have a poorer clinical outcome than those without ETE, but they showed a better outcome than patients with macroscopic ETE.
甲状腺外侵犯（ETE）是甲状腺乳头状癌（PTC）的一个不良预后因素。然而，ETE 的程度，特别是微观 ETE 的影响尚未得到充分确立。本研究的目的是比较根据 ETE 的存在或程度，在临床病理特征和临床结果方面的差异。
分析了 2004 年至 2010 年间 381 例接受全甲状腺切除术伴/不伴淋巴结（LN）清扫术治疗 PTC 的患者的数据。根据 ETE 程度将患者分为三组：无 ETE（n=144）、微观 ETE（n=191）和宏观 ETE（n=46），比较三组之间年龄、性别、LN 转移、包膜侵犯、血管淋巴管侵犯和复发等临床病理特征。
肿瘤大小、LN 转移、血管淋巴管侵犯、手术范围和术后放射性碘（RAI）的应用与 ETE 程度显著相关。特别是在肿瘤大小≤4cm 的患者中，有微观 ETE 的患者比无 ETE 的患者有更多的 LN 转移和血管淋巴管侵犯，而比有宏观 ETE 的患者有更少的 LN 转移和血管淋巴管侵犯。此外，微观 ETE 组的 5 年无复发生存率（RFS）明显低于无 ETE 组（92.1%比 99.3%，p<0.001），明显高于宏观 ETE 组（92.1%比 65.2%，p<0.001）。
ETE 程度与临床病理特征和肿瘤复发相关。有微观 ETE 的患者比无 ETE 的患者临床结局较差，但比有宏观 ETE 的患者临床结局较好。
