多灶性甲状腺乳头状癌的临床病理分析

Clinicopathologic analysis of multifocal papillary thyroid carcinoma

目的:探讨多灶性甲状腺乳头状癌的临床病理特点与侵袭性的关系。方法:选取2013-2018年首次接受甲状腺全切或次全切除手术且术后病理证实为甲状腺乳头状癌的病例共367例,将其分为多灶组和单灶组,对2组各项临床病理参数进行回顾性分析。结果:与单灶组相比,多灶组男性病人比例、含有≥1 cm癌灶的非单纯微小癌病例比例、颈部淋巴结转移率、发生腺外组织侵犯的比例较高(P<0.05~P<0.01),单纯性微小癌的病例比例较低(P<0.01),≥45岁以及有无合并结节性甲状腺肿、桥本氏甲状腺炎的病人比例差异无统计学意义(P>0.05)。结论:多发病灶是甲状腺乳头状癌的临床特征之一,其较单发病灶者更易发生颈部淋巴结转移和甲状腺外侵犯,更具有侵袭性。

Objective:To explore the clinicopathologic characteristics of multifocal papillary thyroid carcinoma(MPTC),and its relationship with invasion.Methods:A total of 367 papillary thyroid carcinoma(PTC)cases confirmed by pathology treated with total or subtotal thyroidectomy from 2013 to 2018 were divided into the multifocal group and single focal group.The clinical pathological characteristics in two groups were retrospectively analyzed.Results:Compared with the single focal group,the proportions of male and non-simple micro cancer cases with tumor lesion≥1 cm,rate of cervical lymph node metastasis,and proportion of cases with extra-glandular tissue invasion were higher in multifocal group(P<0.05 to P<0.01).The proportion of cases with simple micro cancer was lower(P<0.01),and the differences of the proportion of cases with≥45 years old complicated with or without nodular goiter and Hashimoto′s thyroiditis were not statistically significant(P>0.05).Conclusions:The multiple lesion is one of the clinical features of PTC,which is more likely to happen cervical lymph node metastasis and extrathyroid invasion,and more aggressive.