Clinicopathological characteristics between papillary thyroid microcarcinoma and papillary thyroid carcinoma of diameter≥2 cm / 中华内分泌代谢杂志

ABSTRACT

Objective:To compare the differences in clinicopathological characteristics between papillary thyroid microcarcinoma (PTMC) and papillary thyroid carcinoma (PTC) with a diameter≥2 cm.Methods:Clinicopathological and follow-up information of 1 404 PTC cases with diameter≤9 cm who received surgery and were confirmed pathologically from January 2010 to May 2017 in the First Hospital of China Medical University were analyzed retrospectively. All cases were divided into PTMC group and diameter ≥2 cm PTC group according to tumor diameter. The diameter of ≥2 cm PTC group was further categorized into two subgroups with 4 cm as the boundary. Clinical and pathological characteristics were analyzed. Meanwhile, risk factors that affected lymph node metastasis and postoperative recurrence of tumor were analyzed as well.Results:(1) A total of 1 404 eligible patients were included, consisting of 1 001 cases (71.3%) of PTMC and 403 cases (28.7%) of PTC of diameter≥2 cm with a median follow-up time of 43.00 (8.00-94.00) months. There were statistical differences in gender, age, serum thyroid stimulating hormone (TSH) level, bilobe, multifocality, cervical lymph node metastasis, extrathyroidal extension, body mass index, postoperative death, postoperative recurrence, and 131I treatment rate between two groups. Age, serum TSH level, bilobe, multifocality, cervical lymph node metastasis, extrathyroidal extension, postoperative recurrence, and 131I treatment rate were found statistically different among the PTMC group, 2 cm≤diameter≤4 cm PTC group, and 4 cm<diameter≤9 cm PTC group. (2) The univariate analysis showed that the influencing factors of PTMC with cervical lymph node metastasis included male, younger age, larger tumor diameter, bilobe, multifocality, and extrathyroidal extension. The factors influencing 2 cm≤diameter≤4 cm PTC with cervical lymph node metastasis were younger age and extrathyroidal extension. Extrathyroidal extension and cervical lymph node metastasis were associated with recurrence of PTMC, while older age and larger tumor diameter were related to recurrence of 2 cm≤diameter≤4 cm PTC. (3) After multivariate analysis, age<45 years and larger tumor diameter were independent risk factors for PTMC with cervical lymph node metastasis. Age<45 years was an independent risk factor for 2 cm≤diameter≤4 cm PTC with cervical lymph node metastasis. Larger tumor diameter was an independent risk factor for 2 cm≤diameter≤4 cm PTC with recurrence. Conclusion:Clinicopathological characteristics between PTMC and diameter ≥2 cm PTC were significantly different. Age<45 years and larger tumor diameter were independent risk factors influencing prognosis.