Graves' disease associated with papillary thyroid microcarcinoma:a retrospective case-control analysis / 中华内分泌外科杂志

ABSTRACT

Objective To investigate the clinical characteristics,diagnosis and treatment for Graves' disease associated with papillary thyroid microcarcinoma(PTMC) by retrospectively analyzing domestic and foreign literatures.Methods 32 patients of Graves' disease associated with PTMC treated at the Department of Thyroid Surgery,the First Bethune Hospital of Jilin University from Jun.2008 to Jun.2013 were collected.32 cases of PTMC with normal thyroid function were randomly selected by a random number table method from the same period as control.Results The experimental group had 32 patients aging from 24 to 71 years old,among whom 3 were males,and 29 were females with the male to female ratio was 1∶9.7.15 cases in the experimental group had positive central lymph node metastasis and the other 17 cases were negative,while in the control group 7 cases were positive and 25 cases were negative.The mean number of positive lymph nodes was 3 ± 2.88 in the experimental group and 1.71 ± 1.25 in the control group.The ratio of positive lymph node metastasis(the number of positive lymph nodes/the total number of lymph nodes,and the total number of central lymph nodes was ＞3)was (50.34 ±27.09) ％ in the experimental group and(33.5 ±30.79)％ in the control group.For the above 3 values of central lymph node metastasis,the experimental group were all higher than those of the control group (P =0.035,0.039,0.018 respectively).Conclusions Compared with patients of PTMC,patients of Graves' disease associated with PTMC are more likely to have central lymph node metastasis,more number of positive lymph node and higher metastasis ratio.In order to prevent the postoperative recurrence of Graves' disease and thyroid carcinoma local lymph node,total thyroidectomy plus central lymph node dissection should be the ideal operation method.