Zhongguo linchuang yanjiu (Nov 2023)

Clinicopathological characteristics of multifocal papillary thyroid carcinoma and central lymph node metastasis

  • ZHU Taiyang, HE Ling, XU Kun, CHEN Chen, REN Ming, GAO Guoyu, WANG Gaoyuan

DOI
https://doi.org/10.13429/j.cnki.cjcr.2023.11.004
Journal volume & issue
Vol. 36, no. 11
pp. 1623 – 1627

Abstract

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Objective To analyze the clinicopathological features of multifocal papillary thyroid carcinoma (MPTC) and to explore its treatment strategy. Methods The clinical data of 601 patients with thyroid papillary carcinoma（PTC） who underwent the first thyroid surgery in Jiangsu Province Hospital of Chinese Medicine from July 2016 to October 2019 were analyzed retrospectively. The clinicopathological characteristics of MPTC and solitary papillary thyroid carcinoma (SPTC) were compared, and the risk factors for MPTC and central lymph node metastasis（CLNM） were analyzed. Results Among the 601 cases, there were 202 cases of MPTC, accounting for 33.6%, including 150 cases of bilateral thyroid cancer, accounting for 74.3% of MPTC. Among MPTC patients, the central and lateral neck lymph node metastasis rates were 60.9% (123/202) and 13.4% (27/202), respectively. The proportion of MPTC patients with body mass index (BMI)≥25 kg/m2, combined with Hashimotos thyroiditis (HT), tumor maximum diameter≥1 cm, thyroid capsule invasion, lymph node metastasis in central and lateral neck areas were higher than those in SPTC group (P＜0.05). The proportion of male, age＜55 years old, tumor maximum diameter≥1 cm, sum of tumor maximum diameter≥1 cm and thyroid capsule invasion of patients with CLNM in MPTC patients were higher than those of patients without CLNM (P＜0.05). The proportion of patients with nodular goiter in CLNM patients was lower than that in patients without CLNM (44.7% vs 62.0%, χ2=5.770，P＜0.05). Conclusion The rate of bilateral cancer is high in MPTC patients. PTC patients with BMI≥25 kg/m2, combined with HT and thyroid capsule invasion are more likely to have MPTC, and total thyroidectomy is recommended. The incidence of CLNM is higher in MPTC patients with male, age＜55 years old and thyroid capsule invasion, and bilateral central lymph node dissection is recommended.

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