갑상선 미세유두상암에서 중심경부림프절 전이의 관련인자와 양상 = Clinically Related Factors and Features of Central Compartment Neck Lymph Nodes in Thyroid Micropapillary Carcinoma

다국어 초록 (Multilingual Abstract)

Background and Objectives：Despite the overall excellent prognosis for patients with thyroid papillary microcarcinoma (PMC),
PMC is associated with central compartment lymph node metastasis. The aim of this study is to evaluate the effect of clinical
and pathological factors affecting the central compartment lymph node metastasis in thyroid PMC. Subjects and Method：We
undertook a retrospective study of 161 patients treated between January, 2003 and June, 2007 for papillary thyroid microcarcinoma
by total thyroidectomy and central compartment neck dissection (n=161) with or without comprehensive lateral neck
dissection. Following factors were included to analyze the relationship of tumor size and central compartment lymph node metastasis；
sex, age, extracapsular extension, lymphovascular tumor emboli, multifocality, bilaterality, AMES risk group, lateral
cervical lymph node involvement. Results：In 109 of 161 patients (67.7%), tumor size between 5-10 mm was significantly
related with extracapsular extension (p=0.027) and also with the AMES high risk group (p=0.007). In 75 of 161 patients
(46.6%), central compartment lymph node metastasis were found. By univariate analysis, tumor multifocality, bilaterality, and
lateral lymph node involvement were related with central compartment lymph node metastasis. But on multivariate analysis,
tumor bilaterality (p=0.008) and lateral lymph node involvement (p=0.018) were significantly related with central compartment
lymph node metastasis. Conclusion：Prophylactic neck dissection of central compartment lymph nodes in PMC should be
recommended as a routine procedure particularly for patients with tumor bilaterality and metastatic lymph nodes in the lateral
neck.

참고문헌 (Reference)

1 이상혁, "갑상선 미세유두상암의 임상양상" 대한이비인후과학회 50 (50): 627-631, 2007

2 Pacini F, "Why do we need guidelines for differentiated thyroid cancer?" 16 (16): 103-104, 2006

3 Ruggieri M, "Surgical treatment of differentiated microcarcinomas of the thyroid" 5 (5): 85-89, 2001

4 Lee SH, "Predictive factors for central compartment lymph node metastasis in thyroid papillary microcarcinoma" 118 (118): 659-662, 2008

5 Corapcioglu D, "Papillary thyroid microcarcinomas of the thyroid gland and immunohistochemical analysis of expression of p53 protein in papillary microcarcinomas" (4) : 28-, 2006

6 Chow SM, "Papillary microcarcinoma of the thyroid-prognostic significance of lymph node metastasis and multifocality" 98 (98): 31-40, 2003

7 Shaha AR, "Papillary microcarcinoma of the thyroid" 95 (95): 532-533, 2007

8 Kasai N, "New subgrouping of small thyroid carcinomas" 60 (60): 1767-1770, 1987

9 Baudin E, "Microcarcinoma of the thyroid gland: The Gustave-Roussy institute experience" 83 (83): 553-559, 1998

10 Cooper DS, "Management guidelines for patients with thyroid nodules and differentiated thyroid cancer" 16 (16): 109-142, 2006

11 Wada N, "Lymph node metastasis from 259 papillary thyroid microcarcinomas: Frequency, patten of occurrence and recurrence, and optimal strategy for neck dissection" 237 (237): 399-407, 2003

12 Gülben K, "Incidental papillary microcarcinoma of the thyroid-factors affecting lymph node metastasis" 393 (393): 25-29, 2008

13 Lee JH, "Frequent, aggressive behaviors of thyroid microcarcinomas in Korean patients" 53 (53): 627-632, 2006

14 Sanders LE, "Differentiated thyroid cancer. Reexamination of risk groups and outcome of treatment" 133 (133): 419-425, 1998

15 Ito Y, "Clinical significance of metastasis to the central compartment from papillary microcarcinoma of the thyroid" 30 (30): 91-99, 2006

16 White ML, "Central lymph node dissection in differentiated thyroid cancer" 31 (31): 895-904, 2007

17 Cappelli C, "Aggressiveness and outcome of papillary thyroid carcinoma (PTC) versus microcarcinoma (PMC): A mono-institutional experience" 95 (95): 555-560, 2007