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5 mm 이하의 유두 갑상선 미세암에서 림프절 전이와 관련된 예측인자
류희선,노혜원,조진성,박민호,윤정한,제갈영종,Hee-Seon Ryu,M.D.,Hye-Won Ro,M.D.,Jin-Seong Cho,M.D.,Min-Ho Park,M.D.,Jung-Han Yoon,M.D. and Young-Jong Jegal,M.D. 대한갑상선-내분비외과학회 2007 The Koreran journal of Endocrine Surgery Vol.7 No.4
Purpose: Papillary thyroid cancer is the most common histological type of malignancy that originates from the thyroid. The disease has an excellent prognosis, despite characteristically being associated with lymph node metastases. According to the World Health Organization, a papillary thyroid microcarcinoma (PTMC) is defined as papillary carcinoma measuring ≤1 cm in the greatest dimension. We present the clinico-pathological features and investigate predictive factors related with lymph node metastases in patients with papillary thyroid microcarcinomas less than 5 mm in size. Methods: Between January 2003 and June 2005, 75 patients underwent surgical treatment for thyroid papillary cancer less than 5 mm in size at the Department of Endocrine Surgery at our hospital. We analyzed the age of patients, gender, presence of symptoms, multifocality, combined thyroid disease, tumor size, capsular invasion, presence of a lymph node metastasis, tumor location, operative method and postoperative complications by use of Pearson's chi-squared test. Results: Lymph node metastases most frequently occurred in patients with a lateral neck mass at presentation (p= 0.004). Patients with capsular invasion of the thyroid showed a high rate of lymph node metastases (p=0.027). In patients with combined thyroid disease such as thyroiditis, more lymph node metastases were observed (p= 0.018). Conclusion: Preoperative symptoms at presentation (especially a lateral neck mass) and tumors with capsular invasion had a high potential to cause lymph node metastases. Factors such as a lateral neck mass, capsular invasion, and combined thyroiditis may be predictive of a lymph node metastasis and are helpful in the determination of proper treatment. (Korean J Endocrine Surg 2007;7: 242-245)
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