CAJ | 학술논문

目的：探讨甲状腺微小乳头状癌的临床病理特征及其生物学行为与预后的关系。方法收集2012至2014年254例（男性55例，女性199例）甲状腺微小乳头状癌的病理资料，对蜡块行免疫组织化学标记，镜下观察，结合B超影像学特征，对结果进行统计分析。结果甲状腺微小乳头状癌好发于女性，发病年龄集中在41～50岁，占43．3％（110／254）。 B超下表现低回声结节，多伴有钙化。肿瘤病灶直径≥0．5～1．0 cm，占病例数67．3％（171／254），该组易于颈部淋巴结转移，同时该组多发生在41岁以上年龄组中，差异具有统计学意义（ P＜0．05）。免疫组织化学标记CK19、Galectin－3和甲状腺转录因子－1等可以明确诊断。39．4％（100／254）的病例有桥本甲状腺炎的病史。结论甲状腺微小乳头状癌好发于女性，发病年龄集中在41～50岁；直径≥0．5～1．0 cm较易颈部淋巴结转移，但预后良好。桥本甲状腺炎与甲状腺乳头状癌的发生发展关系存在不确定性。
목적：탐토갑상선미소유두상암적림상병리특정급기생물학행위여예후적관계。방법수집2012지2014년254례（남성55례，녀성199례）갑상선미소유두상암적병리자료，대사괴행면역조직화학표기，경하관찰，결합B초영상학특정，대결과진행통계분석。결과갑상선미소유두상암호발우녀성，발병년령집중재41～50세，점43．3％（110／254）。 B초하표현저회성결절，다반유개화。종류병조직경≥0．5～1．0 cm，점병례수67．3％（171／254），해조역우경부림파결전이，동시해조다발생재41세이상년령조중，차이구유통계학의의（ P＜0．05）。면역조직화학표기CK19、Galectin－3화갑상선전록인자－1등가이명학진단。39．4％（100／254）적병례유교본갑상선염적병사。결론갑상선미소유두상암호발우녀성，발병년령집중재41～50세；직경≥0．5～1．0 cm교역경부림파결전이，단예후량호。교본갑상선염여갑상선유두상암적발생발전관계존재불학정성。
Objective To evaluate the prognostic impact of tumor size, ultrasonography, central neck lymph node involvement, and age of patients in papillary thyroid microcarcinoma ( PTMC) .Methods Two hundred and fifty-four patients who underwent total thyroidectomy and central neck dissection for PTMC between 2012 and 2014 were included in this retrospective study.Statistical correlation between tumor size and various clinicopathological parameters was assessed by univariate and multivariate analyses. The ultrasound findings were also evaluated.Results A total of 254 patients (199 females and 55 males) were included in this study.PTMC showed a predilection for female patients, 41-50 years of age (43.3%of all cases, 110/254), and ultrasound showed hypoechoic nodules.Statistically significant correlation was demonstrated between central neck lymph node involvement and the following factors:age and tumor size.A tumor diameter greater than 0.5 mm (67.3%of all cases) most commonly occurred in patients older than 41 years, and was associated with a higher risk of metastatic central neck lymph node involvement (P<0.05). Hashimoto′s thyroiditis was noted in the background in 39.4%( 100/254 ) of cases.Conclusions Tumor size appears to have a prognostic impact in PTMC, and larger size is more likely to be associated with a higher risk of central neck lymph node involvement.It is controversial whether the etiology of papillary thyroid carcinoma is related to Hashimoto′s thyroiditis.