外科，兹林 EUC 诊所的甲状腺微小乳头状癌和甲状腺乳头状癌。

Papillary thyroid microcarcinoma and papillary thyreoid cancer at the Department of Surgery, EUC Clinic Zlín.

出版信息

Rozhl Chir. 2020 Winter;99(11):487-491.

Abstract

INTRODUCTION

Papillary thyroid cancer (PTC), especially micropapillary variant (MPTC), is the most common thyroid malignancy. Biological behavior is not aggressive and the patients prognosis is satisfactory. The objective of our comparative retrospective study was to evaluate whether the incidence is rising in the Region of Zlín and if less extensive approach was adopted by Czech endocrinologists.

METHODS

We compared 2 groups from years 2005-2008 and 2014-2018. The incidence of thyroid cancer, the PTC and the MPTC, the extent of the surgery and the lymphadenectomy, number of removed lymph nodes and the number of positive lymph nodes were observed.

RESULTS

We gathered 1353 patients in group 1. We found 220 malignancies (16.3%), 180 (81.8%) were PTC with MPTC variant in 44.4% (80 patients). All patients underwent a total thyroidectomy. We made 18 central and 10 lateral lymphadenectomies, 280 lymph nodes were collected with meta-stasis in 29,3 %. In group 2 with 1569 patients we found 318 (20.3%) carcinomas, PTC in 302 (94.6%) cases. The MPTC accounted for 215 (67.4%) cases. 10 patients with MPTC underwent hemithyroidectomy only. Numbers of central and lateral lymphadenectomies rose to 52 and 24 respectively. We gathered 376 lymph nodes with proven metastasis in 44.4% of these nodes.

CONCLUSION

Both, the incidence and the frequency of PTC and MPTC are rising in our region. However, the number of less invasive procedures is not increasing significantly despite representing a sufficient way of treatment. We need wider adoption of these evidence-based recommendations by indicating endocrinologists in the Czech Republic.

摘要

简介

甲状腺乳头状癌（PTC），尤其是微乳头状变异型（MPTC），是最常见的甲状腺恶性肿瘤。其生物学行为并不具有侵袭性，患者的预后通常较好。我们的这项回顾性对比研究旨在评估甲状腺癌，包括 PTC 和 MPTC 的发病率在兹林地区是否呈上升趋势，以及捷克内分泌学家是否采用了侵袭性更小的治疗方法。

方法

我们对比了 2005-2008 年和 2014-2018 年的两组患者。观察甲状腺癌、PTC 和 MPTC 的发病率，手术和淋巴结清扫的范围，切除的淋巴结数量和阳性淋巴结的数量。

结果

我们在第 1 组中收集了 1353 例患者，发现了 220 例恶性肿瘤（16.3%），其中 180 例（81.8%）为 PTC，44.4%（80 例）为 MPTC 变异型。所有患者均接受了全甲状腺切除术。我们进行了 18 例中央和 10 例侧方淋巴结清扫术，共采集了 280 个淋巴结，其中 29.3%有转移。在包含 1569 例患者的第 2 组中，我们发现了 318 例（20.3%）癌，其中 PTC 为 302 例（94.6%），MPTC 为 215 例（67.4%）。10 例 MPTC 患者仅接受了半甲状腺切除术。中央和侧方淋巴结清扫术的数量分别增加到 52 例和 24 例。我们共采集了 376 个有转移证据的淋巴结，其中 44.4%的淋巴结有转移。