| Objective: Papillary thyroid microcarcinoma(PTMC)has become a hot topic in thyroid cancer research in recent years.As a special subtype of papillary thyroid carcinoma(PTC),the prognosis of PTMC is good,but there are still some patients with poor performance in invasiveness and prognosis,such as with lymph node metastasis,postoperative recurrence or death.At present,there are few comparative studies on PTMC and large PTC.The choice of large PTC(>1 cm)always includes diameter between 1 and 2 cm PTC,but in clinical practice it may be difficult to distinguish them from PTMC of diameter about 1 cm.The purpose of this study was to compare the difference in clinicopathologic features between PTMC group and diameter? 2 cm PTC group,in order to better distinguish the two groups of patients.Methods: A total of 1405 patients with PTC who underwent surgical treatment and confirmed by pathology during the period from January 2010 to May 2017 in the First Hospital of China Medical University were selected,including 1002 cases of the PTMC group and 403 cases of the PTC with diameter? 2cm group.The clinical pathological information was collected through medical records,and follow up information was obtained via telephone follow up and/or medical records.Results: 1.sex(P = 0.028),age(P = 0.002),serum TSH level(P = 0.002),bifoliate(P =0.000),multifocal(P = 0.000),cervical lymph node metastasis(P = 0.000),BMI(P =0.039),in these clinical pathological information the PTMC group and the diameter?2cm PTC group had statistical differences;death(P = 0.002),recurrence(P = 0.000),including recurrence within the gland(P = 0.010),recurrence in cervical lymph nodes(P= 0.000),and distant recurrence(P = 0.044),as well as postoperative I-131 treatment(P= 0.000),in these follow up information the PTMC group and the diameter? 2cm PTC group had statistical differences.2.The result of univariate analysis of PTMC with cervical lymph node metastasis included male(P = 0.003),younger age(P = 0.000),increased tumor diameter(P = 0.000),bifoliate(P = 0.000),and multifocal(P = 0.000).Multivariate analysis result: the age of < 45 years(OR = 7.585,95%CI 2.901-19.830,P= 0.000),increased tumor diameter(every 1mm increase OR = 1.286,95%CI1.061-1.558,P = 0.010)had statistical significance.3.The result of univariate analysis of diameter? 2cm PTC with cervical lymph node metastasis was younger age(P = 0.001).Multivariate analysis result: the age of < 45 years(OR = 2.187,95%CI 1.135-4.213,P =0.019)had statistical significance.4.The result of univariate analysis that affected the recurrence of diameter? 2cm PTC included older age(P = 0.009)and increased tumor diameter(P = 0.006).Multivariate analysis result: older age(every 1 year increase OR =1.067,95%CI 1.017-1.120,P = 0.008)had statistical significance.Conclusions: 1.The diameter? 2cm PTC group had higher proportion of male,smaller age,higher serum TSH level,higher proportion of cervical lymph node metastases,higher mortality,higher postoperative recurrence(including recurrence within the gland,recurrence in cervical lymph nodes,distant recurrence)rate,higher postoperative I-131 treatment rate;the PTMC group had higher proportion of bifoliate and multifocal,and the BMI was higher.2.age < 45 and increased tumor diameter were independent risk factors for PTMC with cervical lymph node metastasis.3.age < 45 was an independent risk factor for diameter? 2cm PTC with cervical lymph node metastasis.4.older age was an independent risk factor for recurrence of diameter? 2cm PTC. |
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