What features predict poorer outcomes in micro papillary thyroid carcinoma: a retrospective cohort study.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2025-03-12 DOI:10.1016/j.eprac.2025.03.003

Shahaboddin Khamooshi, Soghra Rabizadeh, Leila Seddigh, Sahar Karimpour Reyhan, Fatemeh Mohammadi, Amirhossein Yadegar, Elahe Saffari, Alireza Esteghamati, Manouchehr Nakhjavani

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Abstract

Objective: Micro papillary thyroid carcinoma (MPTC), a variant of papillary thyroid carcinoma (PTC) sized ≤10 mm, is increasingly detected due to advanced ultrasound. This study aimed to describe characteristics and risk assessment of patients with Micro papillary thyroid carcinoma to predict outcomes and guide initial management.

Methods: This retrospective cohort study (June 1980 - September 2023) assessed patients with MPTC using 2015 ATA (American Thyroid Association) guidelines for risk stratification and determination of response to treatment. Outcomes ranged from excellent to structural incomplete responses.

Results: Among 208 patients with PTC with a primary tumor focus ≤10 mm, 68.8% were low-risk, 29.3% intermediate-risk, and 1.9% high-risk. Higher risk was linked to larger tumor size (≥7 mm) (OR=3.196, p-value=0.001) and multifocality (OR=2.431, p-value=0.004). Age (OR=0.973, p-value=0.048) and background Hashimoto's thyroiditis (OR=0.439, p-value=0.014) was found as protective factors. Excellent response to therapy observed in 48.4% of patients; while structural and biochemical incomplete responses were found to be 11.2% and 7.5%. Recurrence was detected in 14 (8.18%) patients.

Conclusion: MPTC generally has a good prognosis and responds well to the treatment. Larger tumors (≥7 mm), younger age (<40 years), multifocality and absence of Hashimoto's thyroiditis correlate with a higher ATA risk and poorer outcomes.

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目的：甲状腺微乳头状癌（MPTC）是甲状腺乳头状癌（PTC）的一种变异型，体积小于10毫米，由于超声检查的先进性，越来越多的甲状腺微乳头状癌被发现。本研究旨在描述甲状腺微乳头状癌患者的特征和风险评估，以预测预后并指导初始治疗：这项回顾性队列研究（1980 年 6 月至 2023 年 9 月）采用 2015 ATA（美国甲状腺协会）指南对 MPTC 患者进行了风险分层和治疗反应评估。结果从极佳反应到结构性不完全反应不等：在208名原发肿瘤病灶小于10毫米的PTC患者中，68.8%为低风险，29.3%为中风险，1.9%为高风险。较高风险与肿瘤较大（≥7 毫米）（OR=3.196，P 值=0.001）和多发（OR=2.431，P 值=0.004）有关。年龄（OR=0.973，P值=0.048）和桥本氏甲状腺炎（OR=0.439，P值=0.014）是保护因素。48.4%的患者对治疗有良好反应，而结构和生化反应不完全的患者分别占11.2%和7.5%。14例（8.18%）患者出现复发：结论：一般来说，MPTC 预后良好，对治疗反应良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.