Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
Division of General Surgery, Department of Surgery, Taichung Veterans General, Hospital, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2022 Aug 1;85(8):839-844. doi: 10.1097/JCMA.0000000000000758. Epub 2022 Aug 19.
Total thyroidectomy is the treatment of choice for multinodular goiter (MNG). In some of these cases, incidental thyroid cancer (ITC) is detected postoperatively. Papillary thyroid microcarcinoma (PTMC), the most common type of ITC, has clinical factors and pathologic similarities with ITC that have not been well clarified previously. We investigated the incidence and characteristics of ITC and PTMC in euthyroid patients undergoing total thyroidectomy for MNG.
We retrospectively investigated the data of 151 euthyroid patients who underwent total thyroidectomy for MNG between January 2016 and December 2020. Patients with PTMC were then selected from among those with ITC for further data analysis.
The incidence rates of ITC and PTMC were 31.1% (47/151) and 21.1% (32/151), respectively. The mean age of patients with ITC was 52.8 ± 11.7 years, which was younger than that of patients with benign MNG (57.2 ± 12.5 years, p < 0.05). Bilateral cancer was observed in 17 patients with ITC (17/47, 36.2%) and nine with PTMC (9/32, 28.1%). The numbers of patients in the ITC and PTMC groups whose cancer was not on the side comprising the dominant tumor were 15 (15/47, 31.9%) and 13 (13/32, 40.6%), respectively. The multivariate analysis demonstrated that younger age was a clinical factor associated with ITC and PTMC.
Younger age is a clinical factor for ITC and PTMC. We recommend taking considering clinical factors and pathologic characteristics of ITC and PTC when considering total thyroidectomy in euthyroid patients with MNG.
全甲状腺切除术是治疗多结节性甲状腺肿（MNG）的首选方法。在这些病例中，一些患者术后会发现偶然的甲状腺癌（ITC）。甲状腺微小乳头状癌（PTMC）是最常见的 ITC 类型，其临床因素和病理特征与之前尚未明确的 ITC 有相似之处。我们研究了在甲状腺功能正常的 MNG 患者中进行全甲状腺切除术时，ITC 和 PTMC 的发生率和特征。
我们回顾性调查了 2016 年 1 月至 2020 年 12 月期间 151 例甲状腺功能正常的患者进行全甲状腺切除术治疗 MNG 的资料。然后，从这些 ITC 患者中选择出 PTMC 患者进行进一步数据分析。
ITC 和 PTMC 的发生率分别为 31.1%（47/151）和 21.1%（32/151）。ITC 患者的平均年龄为 52.8±11.7 岁，小于良性 MNG 患者（57.2±12.5 岁，p<0.05）。17 例 ITC 患者（17/47，36.2%）和 9 例 PTMC 患者（9/32，28.1%）双侧癌。在 ITC 和 PTMC 组中，癌症不在主肿瘤所在侧的患者分别有 15 例（15/47，31.9%）和 13 例（13/32，40.6%）。多变量分析表明，年龄较小是 ITC 和 PTMC 的临床相关因素。
年龄较小是 ITC 和 PTMC 的临床相关因素。我们建议在考虑甲状腺功能正常的 MNG 患者行全甲状腺切除术时，应考虑 ITC 和 PTC 的临床因素和病理特征。
