滤泡性甲状腺癌患者的术后超声监测：一项多中心研究

Postoperative ultrasonography surveillance in patients with follicular thyroid carcinoma: a multicenter study.

作者信息

Baek Hye Jin, Kim Dong Wook, Lee Song, Ryoo Inseon, Lee Chang Yoon, Choi Yoon Jung, Sung Jin Yong

机构信息

Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, 51476, South Korea.

Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.

出版信息

Radiol Med. 2017 Jul;122(7):530-537. doi: 10.1007/s11547-017-0753-7. Epub 2017 Mar 14.

DOI:10.1007/s11547-017-0753-7

PMID:28293811

Abstract

OBJECTIVE

This study aimed to evaluate the locoregional recurrence rate of follicular thyroid carcinoma (FTC) and to assess the appropriate frequency of postoperative ultrasonography (US) surveillance for detecting tumor recurrence.

METHODS

The review boards of the seven participating institutions approved this study. From 2000 to 2011, 186 patients underwent at postoperative US at least once; US was performed by experienced radiologists at each institution. Based on the US and histopathological results, locoregional tumor recurrence was assessed.

RESULTS

The T stages of the 186 patients were T1a (8.1%), T1b (21.5%), T2 (39.8%), T3 (30.6%), T4a (0%), and T4b (0%). The N stages were unknown (24.2%), N0 (71.5%), N1a (3.2%), and N1b (1.1%), and the M stages unknown (29.6%), M0 (66.1%), and M1 (4.3%). Tumors recurred in only 6 (3.2%) patients during the follow-up period over 5 years. Among them, no patients showed the initial suspicion of recurrences on routine follow-up US. The session number and interval of postoperative US differed significantly between patients with recurrence and those without recurrence. The mean interval of postoperative follow-up US at the first detection time of tumor recurrence was 37.5 ± 18.5 months (range 9-62 months). Significantly more FTCs were at an advanced N and M stage in the recurrence group than in the non-recurrence group (p < 0.05).

CONCLUSIONS

Routine postoperative US surveillance may be unnecessary for detecting tumor recurrence after thyroid surgery in FTC patients.

摘要

目的

本研究旨在评估滤泡性甲状腺癌（FTC）的局部区域复发率，并评估术后超声（US）监测检测肿瘤复发的合适频率。

方法

七个参与机构的审查委员会批准了本研究。2000年至2011年，186例患者术后至少接受过一次超声检查；超声检查由各机构经验丰富的放射科医生进行。根据超声和组织病理学结果评估局部区域肿瘤复发情况。

结果

186例患者的T分期为T1a（8.1%）、T1b（21.5%）、T2（39.8%）、T3（30.6%）、T4a（0%）和T4b（0%）。N分期未知（24.2%）、N0（71.5%）、N1a（3.2%）和N1b（1.1%），M分期未知（29.6%）、M0（66.1%）和M1（4.3%）。在超过5年的随访期内，仅6例（3.2%）患者出现肿瘤复发。其中，在常规随访超声检查中，没有患者最初被怀疑复发。复发患者与未复发患者术后超声检查的次数和间隔有显著差异。肿瘤复发首次检测时术后随访超声的平均间隔为37.5±18.5个月（范围9 - 62个月）。复发组中处于晚期N和M分期的FTC明显多于未复发组（p < 0.05）。