Tunca Fatih, Sormaz İsmail Cem, İşcan Ahmet Yalın, Şenyürek Yasemin Giles
Department of General Surgery, İstanbul University Faculty of Medicine, İstanbul, Turkey.
Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2018 Dec 28;52(4):244-248. doi: 10.14744/SEMB.2018.45452. eCollection 2018.
Despite the notable increasing incidence of papillary thyroid microcarcinoma (PTMC), the optimal treatment of the patients with PTMC remains controversial. Because of no consensus about its treatment, the suggested treatment varies from active surveillance alone to total thyroidectomy. Although the 2015 revised American Thyroid Association guideline recommends hemithyroidectomy as the first-line treatment, active surveillance has also been discussed and accepted as another approach for the patients with PTMC. However, the same guideline does not recommend fine needle aspiration biopsy for nodules sized <1 cm, even it is suspicious. In such situation, neither active surveillance nor hemithyroidectomy could be discussed, with a lack of objective cytologic data about the nodules sized <1 cm. In this situation, the decision to perform FNAB to the nodules <1 cm in size depends on the performer of the thyroid ultrasonography. In this invited review, we have discussed the diagnosis and prognostic factors for PTMCs. We have also discussed surgical strategies as the accepted the first-line treatment in patients with PTMC.
尽管甲状腺微小乳头状癌（PTMC）的发病率显著上升，但其最佳治疗方案仍存在争议。由于对其治疗尚无共识，建议的治疗方法从单纯的主动监测到全甲状腺切除术不等。虽然2015年修订的美国甲状腺协会指南推荐甲状腺半切术作为一线治疗方法，但主动监测也已被讨论并被接受为PTMC患者的另一种治疗方法。然而，同一指南不推荐对直径小于1 cm的结节进行细针穿刺活检，即使该结节可疑。在这种情况下，由于缺乏关于直径小于1 cm结节的客观细胞学数据，既无法讨论主动监测也无法讨论甲状腺半切术。在这种情况下，对直径小于1 cm的结节进行细针穿刺活检的决定取决于甲状腺超声检查的操作者。在这篇特邀综述中，我们讨论了PTMC的诊断和预后因素。我们还讨论了作为PTMC患者公认一线治疗方法的手术策略。
