Kasai N, Sakamoto A
Department of Head and Neck Tumor, Cancer Institute Hospital, Tokyo, Japan.
Cancer. 1987 Oct 15;60(8):1767-70. doi: 10.1002/1097-0142(19871015)60:8<1767::aid-cncr2820600816>3.0.co;2-p.
Clinicopathologic findings on small thyroid carcinomas measuring 10 mm or less in diameter were analyzed in 78 thyroidectomied cases. The authors divided small thyroid tumors into two subgroups according to diameter: 0 less than or equal to 5 mm (classified as minute carcinoma) and 5 less than 0 less than or equal to 10 mm (classified as tiny carcinomas). Characteristics including sex, age, histologic type, extrathyroid invasion, and lymph node metastasis were examined in each subgroup. In patients with minute carcinoma, very few incidences of extrathyroid invasion and lymph node metastasis were found. However, these involvements, especially lymph node metastasis, were found more frequently in patients with tiny carcinoma. The incidence of cervical lymph node metastasis was 13% in minute carcinoma and 59% in tiny carcinoma. (P less than 0.01). These findings suggest the need for more careful observation and treatment of tiny carcinomas, especially with respect to lymph node metastasis. In accordance with World Health Organization (WHO) classification, the histologic types of thyroid carcinoma were classified into papillary and follicular carcinomas. The papillary carcinoma and follicular carcinoma ratios were compared between the two subgroups. The discovery rate of follicular carcinoma was significantly higher in minute carcinoma than in tiny carcinoma (P less than 0.005). This suggests that the papillary carcinoma/follicular carcinoma ratio (p/f) increases as the size of the carcinoma increases, and that follicular carcinoma is the "seed," or initial form, of thyroid cancer. The female-male ratio in small thyroid cancer suggests that there is no sex difference in carcinogenesis but that there is more probability for cancer development in the thyroid in women.
对78例接受甲状腺切除术的病例进行分析，以研究直径10mm及以下的小甲状腺癌的临床病理特征。作者根据直径将小甲状腺肿瘤分为两个亚组：0≤5mm（归类为微小癌）和5＜0≤10mm（归类为微小癌）。对每个亚组的性别、年龄、组织学类型、甲状腺外侵犯及淋巴结转移等特征进行了检查。在微小癌患者中，甲状腺外侵犯和淋巴结转移的发生率极低。然而，这些侵犯，尤其是淋巴结转移，在微小癌患者中更为常见。微小癌患者颈部淋巴结转移的发生率为13%，微小癌患者为59%。（P＜0.01）。这些发现表明，对于微小癌，尤其是淋巴结转移方面，需要更仔细的观察和治疗。根据世界卫生组织（WHO）分类，甲状腺癌的组织学类型分为乳头状癌和滤泡状癌。比较了两个亚组之间乳头状癌和滤泡状癌的比例。微小癌中滤泡状癌的发现率显著高于微小癌（P＜0.005）。这表明乳头状癌/滤泡状癌比例（p/f）随着癌的大小增加而增加，并且滤泡状癌是甲状腺癌的“种子”或初始形式。小甲状腺癌的男女比例表明，在致癌过程中不存在性别差异，但女性甲状腺发生癌症的可能性更大。
