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确诊为甲状腺乳头状癌患者的甲状腺切除术完成情况:对侧叶肿瘤是否存在预测因素?

Completion Thyroidectomy in Patients Diagnosed with Papillary Thyroid Cancer: Is There a Predictive Factor for Contralateral Lobe Tumor?

作者信息

Kaya Cemal, Bozkurt Emre, Ömeroğlu Sinan, Mihmanlı Mehmet, Uludağ Mehmet

机构信息

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

出版信息

Sisli Etfal Hastan Tip Bul. 2018 Dec 28;52(4):262-267. doi: 10.14744/SEMB.2018.83713. eCollection 2018.

Abstract

OBJECTIVES

Completion thyroidectomy (CT) is defined as the removal of the residual thyroid tissue in the case of detected malignancy after lobectomy for an indeterminate or non-diagnostic biopsy. Factors such as tumor diameter, aggressive histology, extrathyroidal spread, and positive surgical margin in papillary thyroid cancer (PTC) constitute CT indications. However, the type of surgery is controversial especially in patients with a tumor diameter of 1-4 cm. Determination of predictive factors for contralateral lobe tumors (CLTs) in PTC may be helpful for rough or excessive treatment of patients with this common thyroid pathology.The aim of the present study was to determine the predictive factors and rate of detection of CLTs after CT in patients with papillary thyroid carcinoma after lobectomy.

METHODS

Medical records of patients who underwent lobectomy with the final histological diagnosis of papillary thyroid carcinoma for the study period 2011 to 2016 were reviewed. Demographic data of the patients, diameter, multicentricity and subtype of tumor, extrathyroidal spread, and vascular invasion rate were obtained. Patients were divided into 2 groups as final histological examination after CT revealed benign (Group 1) and malignant (Group 2).

RESULTS

Data of 49 patients were retrospectively analyzed during the study period. The female-to-male ratio was 33/16. The mean age of the patients was 47.59 (23-77) years. Groups 1 and 2 consisted of 30 and 19 patients, respectively. No significant difference was found between the two groups regarding demographic data and tumor characteristics.

CONCLUSION

Despite the fact that we have not been detecting any predictive factor in predicting the presence of tumor on the contralateral lobe in our study, the detection of a tumor on the contralateral lobe is frequent.

摘要

目的

完成甲状腺切除术(CT)定义为在对不确定或非诊断性活检进行叶切除术后检测到恶性肿瘤的情况下切除残余甲状腺组织。甲状腺乳头状癌(PTC)中的肿瘤直径、侵袭性组织学、甲状腺外扩散和手术切缘阳性等因素构成了CT的指征。然而,手术类型存在争议,尤其是对于肿瘤直径为1 - 4 cm的患者。确定PTC中对侧叶肿瘤(CLT)的预测因素可能有助于对这种常见甲状腺疾病患者进行粗略或过度治疗。本研究的目的是确定叶切除术后甲状腺乳头状癌患者CT后CLT的预测因素和检测率。

方法

回顾了2011年至2016年研究期间接受叶切除术且最终组织学诊断为甲状腺乳头状癌的患者的病历。获取患者的人口统计学数据、肿瘤直径、多中心性和亚型、甲状腺外扩散以及血管侵袭率。患者分为两组,CT后最终组织学检查显示为良性(第1组)和恶性(第2组)。

结果

在研究期间对49例患者的数据进行了回顾性分析。男女比例为33/16。患者的平均年龄为47.59(23 - 77)岁。第1组和第2组分别由30例和19例患者组成。两组在人口统计学数据和肿瘤特征方面未发现显著差异。

结论

尽管在我们的研究中尚未检测到任何预测对侧叶肿瘤存在的预测因素,但对侧叶肿瘤的检测很常见。

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