Ruiz Pardo J, Ríos Zambudio A, Rodríguez González J M, Paredes Quiles M, Soriano Giménez V, Oviedo Ramírez M I, Hernández Martínez A M, Parrilla Paricio P
Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Instituto Murciano de Investigación Bio-Sanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, España; Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Universidad de Murcia, Murcia, España.
Rev Clin Esp. 2021 Mar;221(3):131-138. doi: 10.1016/j.rce.2019.12.010. Epub 2020 Mar 23.
Although the incidence of papillary thyroid microcarcinoma (PTMC) has increased in recent decades, the role played by minimal extrathyroidal extension (mETE) in the prognosis of PTMC is still unclear. The aim of this study is to analyze the factors associated with PTMC with mETE and its long-term prognosis.
We conducted a retrospective study on patients with a histological diagnosis of PTMC. We excluded patients who had previously undergone thyroid surgery, those who had other synchronous malignancies, those with an ectopic location of the PTMC, and those lost to follow-up within 2years. We compared group 1 (PTMC without extrathyroidal extension) to group 2 (PTMC with mETE) and performed a multivariate analysis.
We observed PTMC with mETE in 11.2% (n=18) of patients. On the multivariate analysis, mETE was associated with age ≥45 years (OR: 4.383; 95% CI: 1.051-18.283, p = .043), tumor size ≥8mm (OR: 5.913; 95% CL: 1.795-19.481; p = .003), bilaterality (OR: 4.430; 95% CI: 1.294-15.173; p = .018) and metastatic lymph nodes (OR: 12.588; 95% CI: 2.919-54.280; p = .001). During a mean follow-up of 119.8±65 months, one recurrence was detected in group 2 (0% vs. 5.6%; p = .112). No patients died of the disease. Disease-free survival was lower in group 2 (124.9±5.6 vs. 97.4±10.3 months; p = .034).
The mETE of PTMC is a factor of worse prognosis associated with the presence of metastatic lymph nodes and a lower rate of disease-free survival.
尽管近几十年来甲状腺微小乳头状癌（PTMC）的发病率有所上升，但最小甲状腺外侵犯（mETE）在PTMC预后中所起的作用仍不清楚。本研究的目的是分析与伴有mETE的PTMC相关的因素及其长期预后。
我们对经组织学诊断为PTMC的患者进行了一项回顾性研究。我们排除了先前接受过甲状腺手术的患者、患有其他同步恶性肿瘤的患者、PTMC异位的患者以及在2年内失访的患者。我们将第1组（无甲状腺外侵犯的PTMC）与第2组（伴有mETE的PTMC）进行比较，并进行多因素分析。
我们在11.2%（n = 18）的患者中观察到伴有mETE的PTMC。在多因素分析中，mETE与年龄≥45岁（OR：4.383；95%CI：1.051 - 18.283，p = 0.043）、肿瘤大小≥8mm（OR：5.913；95%CL：1.795 - 19.481；p = 0.003）、双侧性（OR：4.430；95%CI：1.294 - 15.173；p = 0.018）和转移性淋巴结（OR：12.588；95%CI：2.919 - 54.280；p = 0.001）相关。在平均119.8±65个月的随访期间，第2组检测到1例复发（0%对5.6%；p = 0.112）。无患者死于该疾病。第2组的无病生存期较低（124.9±5.6对97.4±10.3个月；p = 0.034）。
PTMC的mETE是与转移性淋巴结的存在和较低的无病生存率相关的预后较差的因素。
