Clinicopathological analysis of papillary thyroid microcarcinoma in isthmus

doi:10.16139/j.1007-9610.2021.06.014

Abstract

Abstract: Objective To evaluate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) located in the isthmus. Methods The clinical and pathological data of 477 cases with PTMC diagnosed pathologically were retrospectively analyzed. Differences in PTMC between isthmus and lateral lobe were compared. Results Multivariate analysis showed that there were significantly difference in cancer capsule contact (30.5% vs. 10.4%, P=0.001) and lymph node metastasis (LNM) (42.7% vs. 18.7%, P<0.001) of PTMC between isthmus and lateral lobe. When compared with PTMC in lateral lobe, PTMC in isthmus was more prone to in ipsilateral central LNM (41.5% vs. 17.5%, P<0.001), ipsilateral lateral LNM (8.5% vs. 2.8%, P=0.022) and bilateral central LNM (12.2% vs. 0.2%, P<0.001), and contralateral lateral LNM (3.7% vs. 0, P<0.001). Conclusions PTMC in isthmus had capsular contact and LNM with higher proportion compared with PTMC in lateral lobe. It should suggest bilateral central lymph node dissection for PTMC located in isthmus.

Key words: Isthmus, Papillary thyroid microcarcinoma, Clinicopathological feature, Lymph node metastasis, Central group

CLC Number:

R736.1

FAN Jinfang, SHEN Yi, ZHAN Weiwei, TAO Lingling, LI Weiwei, KUANG Lijun, ZHOU Wei. Clinicopathological analysis of papillary thyroid microcarcinoma in isthmus[J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 528-531.

Figures/Tables 4

References 19

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指标	特征	峡部（n=82）	侧叶（n=395）	χ²值	P值
性别	男	19（23.2）	86（21.8）	0.077	0.771
	女	63（76.8）	309（78.2）
年龄（岁）	<45	33（40.2）	170（43.0）	0.217	0.713
	≥45	49（59.8）	225（57.0）
结节最大径（mm）	<5	21（25.6）	91（23.0）	0.250	0.668
	5~10	61（74.4）	304（77.0）
包膜	不接触	57（69.5）	354（89.6）	23.029	<0.001
	接触	25（30.5）	41（10.4）
病理LNM	无转移	47（57.3）	321（81.3）	22.091	<0.001
	转移	35（42.7）	74（18.7）
usLNM	无转移	65（79.3）	355（89.9）	7.258	0.014
	转移	17（20.7）	40（10.1）
合并桥本甲状腺炎	无	64（78.0）	346（87.6）	5.125	0.035
	有	18（22.0）	49（12.4）

指标	回归系数（β）	标准误（SE）	卡方值（Wald）	Df	P值	Exp (β)	95% CI
包膜接触	-1.039	0.315	10.867	1	0.001	0.354	0.191~0.656
病理LNM	-1.287	0.353	13.290	1	<0.001	0.276	0.138~0.552
usLNM	0.150	0.460	0.106	1	0.744	1.162	0.472~2.859
合并桥本甲状腺炎	-0.410	0.350	1.374	1	0.241	0.663	0.334~1.317

LNM	数量和占侧叶 395例百分比	数量和占峡部 82例百分比	χ²值	P值
中央（+）同侧	69（17.5）	34（41.5）	23.092	<0.001
双侧	1（0.2）^a)	10（12.2）	42.983	<0.001
侧方（+）同侧	11（2.8）	7（8.5）	6.187	0.022
对侧	0^a)	3（3.7）^a)	14.543	<0.001