Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, China.
Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.
Am J Clin Pathol. 2020 Nov 4;154(6):848-858. doi: 10.1093/ajcp/aqaa102.
The purpose of this study was to investigate the significance of tumor number on clinicopathologic factors and outcomes of patients with papillary thyroid carcinoma (PTC).
We retrospectively analyzed 667 patients with PTC. We compared clinicopathologic features of patients with a different tumor number. Cox proportional hazards model was used to analyze risk factors of recurrence.
In papillary thyroid microcarcinoma (PTMC), the increase in the number of tumor foci was related to a higher risk of minimal extrathyroidal extension (ETE) and lymphovascular invasion (P < .05). Patients with PTMC with four or more foci had a significantly higher risk of central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) than patients with solitary tumors (P < .05). Patients with macro-PTC with four or more foci and with three foci had a higher risk of gross ETE and lymphovascular invasion than patients with solitary tumors (P < .05). The increase in the tumor number was related to a higher risk of CLNM in macro-PTC (P < .05). The number of foci was the independent predictor of recurrence in patients with macro-PTC (P < .05).
An increase in the number of tumors was associated with an increased risk of aggressive clinicopathologic features in PTMC and macro-PTC. The number of tumor foci could influence risk of recurrence in macro-PTC.
本研究旨在探讨肿瘤数量对甲状腺乳头状癌（PTC）患者临床病理因素和结局的意义。
我们回顾性分析了 667 例 PTC 患者。我们比较了不同肿瘤数量患者的临床病理特征。使用Cox 比例风险模型分析复发的危险因素。
在甲状腺微小乳头状癌（PTMC）中，肿瘤灶数量的增加与微小甲状腺外侵犯（ETE）和血管淋巴管侵犯的风险增加相关（P <.05）。与单发肿瘤患者相比，多发肿瘤（≥4 个）的 PTMC 患者发生中央淋巴结转移（CLNM）和侧方淋巴结转移（LLNM）的风险显著更高（P <.05）。多发肿瘤（≥4 个）和 3 个肿瘤灶的巨大多发 PTC 患者发生大体 ETE 和血管淋巴管侵犯的风险高于单发肿瘤患者（P <.05）。肿瘤数量的增加与巨大多发 PTC 患者 CLNM 风险增加相关（P <.05）。肿瘤灶数量是巨大多发 PTC 患者复发的独立预测因素（P <.05）。
肿瘤数量的增加与 PTMC 和巨大多发 PTC 侵袭性临床病理特征的风险增加相关。肿瘤灶数量可能影响巨大多发 PTC 的复发风险。
