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甲状腺微小乳头状癌和甲状腺乳头状癌:临床特征及治疗策略分层

Papillary thyroid microcarcinoma and papillary thyroid carcinoma: Clinical characteristics and stratification of treatment strategies.

作者信息

Li Congcong, Li Qiang, Shi Xiao, Han Shuang, Song Xiao, Li Xueqian, Zhuang Xuewei

机构信息

Department of Clinical Laboratory, Shizhong District People's Hospital of Jinan, Jinan, Shandong, China.

Department of Surgery, Shizhong District People's Hospital of Jinan, Jinan, Shandong, China.

出版信息

PLoS One. 2025 Jul 9;20(7):e0327423. doi: 10.1371/journal.pone.0327423. eCollection 2025.

Abstract

AIM

Exploring the clinical differences between papillary thyroid micarcinoma (PTMC) and papillary thyroid carcinoma (PTC), optimizing clinical decision-making pathways, and reducing excessive medical behavior while ensuring therapeutic efficacy.

METHOD

Patients diagnosed with PTMC or PTC by pathological histology from May 2023 to May 2024 at Jinan Shizhong District People's Hospital were retrospectively analyzed. PTMC refers to thyroid papillary carcinoma with a maximum diameter of ≤1 cm.

RESULTS

There were 186 patients (PTMC group) whose maximum tumor diameter was ≤ 1 cm and 45 patients (PTC group) whose maximum tumor diameter was > 1 cm. The patient's age was (45.97 ± 10.63) years for the PTMC group and (45.31 ± 11.55) years for the PTC group. No statistically significant differences existed between the two groups in sex, age, BRAF V600E gene mutation, tumor multifocality, and capsular invasion (P > 0.05). Between the two groups, there were statistically significant (P < 0.05) differences in TNM staging, the thyroid imaging reporting and data system (TI-RADS) staging, and cervical lymph node metastasis.

CONCLUSIONS

Thyroid surgery, thermal ablation, and active monitoring are different approaches in the stratified treatment of PTMC and PTC. To avoid overtreatment and improve the quality of life of the patients, personalized treatment plans should be developed according to the test results of TNM stage, TI-RADS classification, and cervical lymph node metastasis.

摘要

目的

探讨甲状腺微小乳头状癌(PTMC)与甲状腺乳头状癌(PTC)的临床差异,优化临床决策路径,在确保治疗效果的同时减少过度医疗行为。

方法

回顾性分析2023年5月至2024年5月在济南市市中区人民医院经病理组织学诊断为PTMC或PTC的患者。PTMC是指最大直径≤1 cm的甲状腺乳头状癌。

结果

最大肿瘤直径≤1 cm的患者186例(PTMC组),最大肿瘤直径>1 cm的患者45例(PTC组)。PTMC组患者年龄为(45.97±10.63)岁,PTC组患者年龄为(45.31±11.55)岁。两组在性别、年龄、BRAF V600E基因突变、肿瘤多灶性和包膜侵犯方面差异无统计学意义(P>0.05)。两组在TNM分期、甲状腺影像报告和数据系统(TI-RADS)分期及颈部淋巴结转移方面差异有统计学意义(P<0.05)。

结论

甲状腺手术、热消融和主动监测是PTMC和PTC分层治疗的不同方法。为避免过度治疗并提高患者生活质量,应根据TNM分期、TI-RADS分类及颈部淋巴结转移的检查结果制定个性化治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bc/12240312/94ab3fac7872/pone.0327423.g001.jpg

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