Sugino K, Ito K, Ozaki O, Mimura T, Iwasaki H, Ito K
Ito Hospital, Tokyo, Japan.
J Endocrinol Invest. 1998 Jul-Aug;21(7):445-8. doi: 10.1007/BF03347324.
Papillary microcarcinoma of the thyroid has been often detected by aspiration biopsy cytology performed with ultrasonographic guidance. Autopsy studies also have often revealed small thyroid carcinomas, and it was concluded that most small thyroid carcinomas should not be regarded as a clinical matter. In this study, 112 patients with papillary microcarcinoma 10 mm or less in size treated between 1992 and 1995 were analyzed. There were 104 females and 8 males, with a mean age of 46.0 years. Diagnosis of papillary carcinoma was made preoperatively in 100 of these patients (89.3%), and 77 patients underwent aspiration biopsy cytology under ultrasound guidance. Seventy of these patients underwent modified neck dissection, and 63.8% of these patients had lymph node metastases. The number of lymph node metastasis increased as primary tumor size increased. There was no clear border or clinical differences between primary tumors 10 mm or less and tumors more than 10 mm. One patient had lymph node recurrence after surgery and another patient had recurrent nerve palsy at the first visit. Based on these findings, papillary microcarcinoma should be treated surgically.
甲状腺微小乳头状癌常通过超声引导下的细针穿刺活检细胞学检查发现。尸检研究也常发现小的甲状腺癌,并且得出结论:大多数小的甲状腺癌不应视为临床问题。在本研究中,对1992年至1995年间治疗的112例直径10毫米及以下的甲状腺微小乳头状癌患者进行了分析。其中女性104例,男性8例,平均年龄46.0岁。这些患者中有100例(89.3%)术前诊断为乳头状癌,77例患者在超声引导下进行了细针穿刺活检细胞学检查。其中70例患者接受了改良颈清扫术,这些患者中有63.8%发生了淋巴结转移。淋巴结转移的数量随着原发肿瘤大小的增加而增加。直径10毫米及以下的原发肿瘤与直径超过10毫米的肿瘤之间没有明显的界限或临床差异。1例患者术后出现淋巴结复发,另1例患者初诊时出现喉返神经麻痹。基于这些发现,甲状腺微小乳头状癌应进行手术治疗。