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326例甲状腺微小乳头状癌临床病理学特点分析

李伟1,孙保存2   

  1. 1. 天津市南开医院病理科
    2. 天津医科大学，天津医科大学附属肿瘤医院
  • 收稿日期:2011-07-19 修回日期:2012-02-08 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 李伟

Papillary thyroid microcarcinoma : a Clinicopathologic analysis of 326 cases

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  • Received:2011-07-19 Revised:2012-02-08 Published:2012-08-15 Online:2012-08-15

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摘要： 摘要 目的：探讨甲状腺微小乳头状癌（PTMC）的临床病理学特点。方法：回顾性分析2001年以及2010年两年内共326例PTMC的临床和病理学资料，对组织学切片应用光学显微镜观察并进行统计学分析。结果：（1）在326例PTMC患者中，2001年39例，其中单灶性病变33例，多灶性病变6例；2010年287例，其中单灶性病变224例，多灶性病变63例。（2）2010年PTMC及多灶性PTMC占全年总甲状腺疾病的检出率显著高于2001年（12.8%,287/2241 vs 5.1%,39/771；2.8%,63/2241 vs 0.8%,6/771，p<0.05），差别具有统计学意义。（3）2001年以及2010年中，多灶性PTMC与单灶性PTMC相比，前者的颈部淋巴结转移率及侵犯包膜情况均显著高于后者（50%,3/6 vs 9.1%,3/33；58.7%,37/63 vs 12.9%,29/224，50%,3/6 vs 9.1%,3/33；33.3%,21/63 vs 6.7%,15/224，p<0.05），差别具有统计学意义。（4）多灶性PTMC常以桥本氏甲状腺肿为背景性病变。结论：在最近10年的甲状腺疾病中，PTMC及多灶性PTMC的检出率显著升高，且后者更容易出现颈部淋巴结的癌转移及包膜侵犯，提示其可能是一组具有侵袭性行为的PTMC，在临床诊疗过程中应予以重视并加强随访。

关键词: 甲状腺微小乳头状癌, 多灶性, 淋巴结转移, 桥本氏甲状腺肿, 流行病学

Abstract: Abstract Objective: To investigate the clinicopathologic characteristics of Papillary thyroid microcarcinoma（PTMC）. Methods: 326 cases of PTMCs in 2001 and 2010 were retrospectively analyzed with the clinicopathologic data. Results: （1）There are 39 PTMCs in 2001, containing 33 unifocal and 6 multifocal lesions; and there are 287 PTMCs in 2010, containing 224 unifocal and 63 multifocal lesions.（2）The incidence of PTMC and multifocal PTMC in 2010 was significantly higher than that in 2001.（3）In 2001 and 2010 receptively, the occuring of lymph node metastasis and capsule infringed in multifocal PTMC is more often than that in unifocal PTMC.（4）Hashimoto’s thyroiditis is frequently presented as background changes in multifocal lesions. Conclusions: The incidence of PTMC and multifocal PTMC increased significantly in past 10 years, and neck lymph node metastasis and capsule infringed is more frequently occurred in the latter one. In conclusion, our studies suggest that multifocal PTMC presented with aggressive behavior, which should be paid more attentions in clinical treatment, and close follow-up are greatly needed.

Key words: Papillary thyroid microcarcinoma, Multifocal, Lymph node metastasis, Hashimoto’s thyroiditis, Epidemiology