Papillary thyroid carcinoma with thyroiditis: lymph node metastasis, complications.

Journal of the Korean Surgical Society Pub Date : 2013-07-01 Epub Date: 2013-06-26 DOI:10.4174/jkss.2013.85.1.20
Yon Seon Kim, Hye-Jeong Choi, Eun Sook Kim
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引用次数: 13

Abstract

Purpose: The aim of this study was to evaluate the clinicopathologic characteristics of papillary thyroid cancer with thyroiditis, and to determine the rate of its complications for it.

Methods: A retrospective review of 1,247 patients with papillary thyroid cancer who underwent primary thyroidectomy was performed. Among them, 316 patients had thyroiditis (group I) while 931 patients had no thyroiditis (group II), as reflected in the final pathologic reports. The two groups' clinicopathologic results and rate of complications were compared.

Results: Female gender, preoperative hypothyroidism, total thyroidectomy, no extrathyroid extension, no lymphovascular invasion, and no perineural invasion were associated with group I. More central lymph nodes were removed in group I than in group II, but there were fewer central lymph nodes with metastasis in group I than in group II. For the lateral lymph nodes, the two groups had the same numbers of removed nodes and nodes with metastatic tumor. Multivariate analysis revealed female predominance, more cases of preoperative hypothyroidism, more dissected lymph nodes, and fewer lymph nodes with metastasis in group I. Among the patients who underwent lobectomy, postoperative hypothyroidism occurred more in group I than in group II (P < 0.001). There was no difference in postoperative complications between the two groups.

Conclusion: Papillary thyroid cancer with thyroiditis showed less aggressive features. Postoperative hypothyroidism occurred more in the patients with thyroiditis.

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甲状腺乳头状癌合并甲状腺炎:淋巴结转移、并发症。
目的:探讨甲状腺乳头状癌合并甲状腺炎的临床病理特点,探讨其并发症的发生率。方法:对1247例行原发性甲状腺切除术的甲状腺乳头状癌患者进行回顾性分析。最终病理报告显示,其中有甲状腺炎316例(I组),无甲状腺炎931例(II组)。比较两组临床病理结果及并发症发生率。结果:女性、术前甲状腺功能减退、全甲状腺切除术、无甲状腺外展、无淋巴血管侵犯、无神经周围侵犯与I组相关。I组中央性淋巴结切除多于II组,但伴有转移的中央性淋巴结少于II组。对于侧淋巴结,两组切除淋巴结和转移淋巴结的数量相同。多因素分析显示,女性占优势,ⅰ组术前甲状腺功能减退较多,淋巴结清扫较多,淋巴结转移较少。在行肺叶切除术的患者中,ⅰ组术后甲状腺功能减退发生率高于ⅱ组(P < 0.001)。两组术后并发症无明显差异。结论:甲状腺乳头状癌合并甲状腺炎侵袭性较弱。术后甲状腺功能减退多见于甲状腺炎患者。
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