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甲状腺微小乳头状癌与乳头状癌的临床病理差异

Clinicopathologic Differences Between Micropapillary and Papillary Thyroid Carcinoma.

作者信息

Kartal Kinyas, Aygün Nurcihan, Uludağ Mehmet

机构信息

Department of General Surgery, Koc University Hospital, Istanbul, Turkey.

Department of General Surgery, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

出版信息

Sisli Etfal Hastan Tıp Bul. 2019 Apr 25;53(2):120-124. doi: 10.14744/SEMB.2019.68790. eCollection 2019.

DOI:10.14744/SEMB.2019.68790
PMID:32377069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7199821/
Abstract

OBJECTIVES

The aim of this study is observing the clinicopathologic features of thyroid papillary microcarcinomas (PTMs) and comparing these features with papillary thyroid carcinoma (PTC).

METHODS

A total of 86 surgically treated patients suffering from PTC were evaluated retrospectively. Group 1 (G1) included patients with a tumor <1 cm, while Group 2 (G2) included patients with a tumor >1 cm. The two groups were compared in terms of the preoperative thyroid-stimulating hormone (TSH) level, anti-thyroid peroxidase antibody (anti-TPO) and antithyroglobulin antibody (TgAb) values, multicentricity, the lymphovascular invasion rate, the presence of extrathyroidal extension, and central and/or lateral lymph node metastasis.

RESULTS

There was no statistically significant difference observed between the groups in terms of the preoperative TSH level, anti-TPO, and TgAb values. The rate of multicentricity of the tumor in G2 was 66%, while it was 36% in G1 (p<0.001). The lymphovascular invasion rate in G1 was 14.2%, while it was 61% in G2 (p<0.001). The extrathyroidal extension rate of the tumor cells in G1 was 21.4%, while it was 63.6% in G2 (p<0.001). The central lymph node metastasis rate in G2 was 38.6%, while it was 4.8% in G1 (p<0.001). The lateral lymph node metastasis rate in G2 was 20.5%, while it was 0% in G1 (p<0.001).

CONCLUSION

PTMs are generally associated with good prognostic factors with high survival rates. However, the risk factors such as multifocality, extrathyroidal extension, and lymphovascular invasion increasing the recurrence risk are not rare in PTM. Thus, the patients having these histopathological features of the tumor should be followed more carefully.

摘要

目的

本研究旨在观察甲状腺微小乳头状癌(PTM)的临床病理特征,并将这些特征与甲状腺乳头状癌(PTC)进行比较。

方法

回顾性评估86例接受手术治疗的PTC患者。第1组(G1)包括肿瘤<1 cm的患者,而第2组(G2)包括肿瘤>1 cm的患者。比较两组患者术前促甲状腺激素(TSH)水平、抗甲状腺过氧化物酶抗体(抗-TPO)和抗甲状腺球蛋白抗体(TgAb)值、多灶性、淋巴管侵犯率、甲状腺外侵犯情况以及中央和/或侧方淋巴结转移情况。

结果

两组患者术前TSH水平、抗-TPO和TgAb值差异无统计学意义。G2组肿瘤多灶性发生率为66%,而G1组为36%(p<0.001)。G1组淋巴管侵犯率为14.2%,而G2组为61%(p<0.001)。G1组肿瘤细胞甲状腺外侵犯率为21.4%,而G2组为63.6%(p<0.001)。G2组中央淋巴结转移率为38.6%,而G1组为4.8%(p<0.001)。G2组侧方淋巴结转移率为20.5%,而G1组为0%(p<0.001)。

结论

PTM通常与良好的预后因素相关,生存率较高。然而,多灶性、甲状腺外侵犯和淋巴管侵犯等增加复发风险的危险因素在PTM中并不少见。因此,具有这些肿瘤组织病理学特征的患者应更密切地随访。