CAJ | 학술논문

目的研究甲状腺乳头状微小癌（PTMC）的预后因素及手术范围。方法检索PTMC的相关研究，通过Meta分析判断多种因素与首次术后复发的关系，对PTMC的手术范围进行探讨。结果共纳入12篇回顾性研究，Meta分析结果显示PTMC首次术后复发与男性、肿瘤直径＞5 mm、非附带、术前诊断淋巴结阳性、多发病灶、侵及包膜等因素相关，与年龄≥45岁无关。预防性颈部淋巴结清扫组与未行颈部淋巴结清扫组之间首次术后复发率差异无统计学意义。结论PTMC的预后与多因素相关，应根据预后因素选择腺叶切除范围，预防性颈部淋巴结清扫不应作为PTMC的常规术式，术前诊断淋巴结阳性的患者可行双侧中央区淋巴结清扫术。
목적 연구갑상선유두상미소암（PTMC）적예후인소급수술범위。방법 검색PTMC적상관연구，통과Meta분석판단다충인소여수차술후복발적관계，대PTMC적수술범위진행탐토。결과공납입12편회고성연구，Meta분석결과현시PTMC수차술후복발여남성、종류직경＞5 mm、비부대、술전진단림파결양성、다발병조、침급포막등인소상관，여년령≥45세무관。예방성경부림파결청소조여미행경부림파결청소조지간수차술후복발솔차이무통계학의의。결론PTMC적예후여다인소상관，응근거예후인소선택선협절제범위，예방성경부림파결청소불응작위PTMC적상규술식，술전진단림파결양성적환자가행쌍측중앙구림파결청소술。
Objective To study prognostic factors and surgical extent of papillary thyroid microcarcinona (PTMC). Methods Literatures about PTMC were searched. Relationship between prognostic factors and recurrence after initial operation was analyzed by meta analysis. The surgical extent of PTMC was discussed. Results A total of 12 retrospective studies were included. Meta analysis results showed that factors such as male, tumor size ＞ 5 mm, nonincidental, positive lymphnode, multifocus, and capsular invasion were related to recurrence after initial surgery. Age above 45 years had nothing to do with the recurrence rate of PTMC. There was no signifi.cant difference in recurrence rate between prophylactic neck dissection groups and the groups without prophylactic neck dissection. Conclusions Many factors are related to the prognosis of PTMC. The surgical extent depends on prognostic factors. Prophylactic neck dissection is not supposed to be conventional surgical procedure for PTMC. Bilateral central lymph node dissection is appropriate to PTMC with positive lymph node.