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家族性甲状腺乳头状微小癌的单中心性与多中心性是否不同?

Is unicentric familial papillary thyroid microcarcinoma different from multicentric?

机构信息

Unidad de Cirugía Endocrina. Servicio de Cirugía General y de Aparato Digestivo. Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca). Hospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, Murcia, Spain.

Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain.

出版信息

Endocrine. 2023 Dec;82(3):613-621. doi: 10.1007/s12020-023-03455-y. Epub 2023 Jul 25.

Abstract

BACKGROUND

Familial papillary thyroid microcarcinoma (FPTMC) appears to be more aggressive than sporadic papillary thyroid microcarcinoma (SPTMC). However, there are authors who indicate that unicentric FPTMC has a similar prognosis to SPTMC. The objective is to analyze whether unicentric FPTMC has a better prognosis than multicentric FPTMC.

DESIGN AND METHODS

Type of study: National multicenter longitudinal analytical observational study.

STUDY POPULATION

Patients with FPTMC.

STUDY GROUPS

Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC).

STUDY VARIABLES

It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences.

STATISTICAL ANALYSIS

Cox regression analysis and survival analysis.

RESULTS

Ninety-four patients were included, 44% (n = 41) with unicentric FPTMC and 56% (n = 53) with multicentric FPTMC. No differences were observed between the groups according to socio-familial, clinical or histological variables. In the group B a more aggressive treatment was performed, with higher frequency of total thyroidectomy (99 vs. 78%; p = 0.003), lymph node dissection (41 vs. 15%; p = 0.005) and therapy with radioactive iodine (96 vs. 73%; p = 0.002). Tumor stage was similar in both groups (p = 0.237), with a higher number of T3 cases in the group B (24 vs. 5%; p = 0.009). After a mean follow-up of 90 ± 68.95 months, the oncological results were similar, with a similar disease persistence rate (9 vs. 5%; p = 0.337), disease recurrence rate (21 vs. 8%; p = 0.159) and disease-free survival (p = 0.075).

CONCLUSIONS

Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC.

摘要

背景

家族性甲状腺乳头状微小癌(FPTMC)似乎比散发性甲状腺乳头状微小癌(SPTMC)更具侵袭性。然而,也有作者指出,单中心 FPTMC 的预后与 SPTMC 相似。目的是分析单中心 FPTMC 是否比多中心 FPTMC 具有更好的预后。

设计和方法

研究类型:全国多中心纵向分析观察性研究。

研究人群

FPTMC 患者。

研究组

比较两组:A 组(单中心 FPTMC)与 B 组(多中心 FPTMC)。

研究变量

分析两组之间是否存在:a)鉴别特征;和 b)预后差异。

统计分析

Cox 回归分析和生存分析。

结果

共纳入 94 例患者,44%(n=41)为单中心 FPTMC,56%(n=53)为多中心 FPTMC。两组在社会家庭、临床或组织学变量方面无差异。在 B 组中,更多地采用了更积极的治疗方法,全甲状腺切除术的频率更高(99%比 78%;p=0.003),淋巴结清扫术的频率更高(41%比 15%;p=0.005),放射性碘治疗的频率更高(96%比 73%;p=0.002)。两组肿瘤分期相似(p=0.237),B 组 T3 病例较多(24%比 5%;p=0.009)。平均随访 90±68.95 个月后,两组的肿瘤学结果相似,疾病持续率相似(9%比 5%;p=0.337),疾病复发率相似(21%比 8%;p=0.159),无疾病生存率相似(p=0.075)。

结论

单中心 FPTMC 不应因其预后与多中心 FPTMC 相似而被视为 SPTMC。

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