A Retrospective Analysis Of Clinical And Pathological Characteristics Of Thyroid Carcinoma

Objective:To analyze the clinical and pathological characteristics of patients with thyroid carcinoma treated in thyroid and breast surgery department of Tongji Hospital in Wuhan. At the same time, to take further analysis for PTMC.Method:From January2003to December2012, all the clinical and pathological materials of1367patients with thyroid carcinoma, who underwent thyroidectomy and pathological examination in Tongji Hospital of Wuhan were reviewed and analyzed. Put all the patients into five groups, and every two years as one group. Analyzed and compared the five groups with age, sex ratio, rate of lymph node metastasis and pathological proportions. And analyzed the possible factors related to lymph node metastasis of papillary thyroid carcinoma. Then compared age, sex ratio, incidence and the accuracy of frozen section examination of patients with PTMC to patients with PTC (d>lcm). And analyzed the possible risk factors associated with lymph node metastasis of PTMC.Results:1. The number of patients with thyroid carcinoma treated in our hospital increased year by year, and the increase of PTC was the most obvious.(1) The proportion of PTC increased from90.43%during2003-2004to96.88%during2011-2012(P<0.01), FTC decreased from7.45%to0.74%(P<0.01), and the proportion of MTC and FVPTC have been stable in recent ten years (P>0.05).(2) The ratio with male to female was1:3.4, and there was no significant change in recent years (P>0.05). The peak age of patients was20-59years, the mean age increased from (36.69±12.022) during2003-2004to (40.22±11.809) during2011-2012(P>0.05). The mean age of male and female were respectively (39.72±13.549) and (39.55±11.949) years (P>0.05).(3) The number of patients with small tumors increased more obviously, especially for PTMC. PTMC accounted for2.35%of all PTC in2003-2004and increased to33.85%in2011-2012(P<0.01). The rate of lymph node metastasis was40.16%, and the rate of central neck lymph node(level VI) metastasis increased from8.5%during2003-2004to19.8%during2011-2012(P<0.01), the rate of lateral neck lymph node (level II-V)±central neck lymph node (level VI) metastasis decreased from36.2%to20.6%(P<0.01), while the total rate of lymph node metastasis has been stable in recent years (P>0.05).(4) d>lcm and bilateral tumors were independent risk factors for PTC with lymph node metastasis. While age was protective factor for it, the risk of lymph node metastasis decreased as age increased (P<0.01).2. The sex ratio (male to female) of patients with PTMC and patients with PTC(d>lcm) were respectively1:4.09and1:3.45(P>0.05); The mean age of patients with PTMC (42.75±11.06) was significantly older than that of PTC (d>1cm)(38.38±12.25)(P<0.01). The accuracy of frozen section examination in patients with PTMC (80.2%) was significantly lower than that of PTC (d>lcm)(95.4%)(P<0.01). The rate of lymph node metastasis in patients with PTMC was13.0%. Male patients and patients with tumor d>5mm were more likely to have lymph node metastasis.Conclusions:1. The number of thyroid carcinoma treated in our hospital increased year by year, with a prominent increase in PTC. The proportion of PTC has increased significantly, and the proportion of FTC has decreased significantly. Although the total rate of lymph node metastasis has been stable, the rate of central neck lymph node(level VI) metastasis increased significantly, and the rate of lateral neck lymph node (level II-V)±central neck lymph node (level VI) metastasis decreased significantly. Young patients, patients with larger tumors and bilateral tumors were more likely to have lymph node metastasis.2. The number of PTMC treated in our hospital also increased year by year. The mean age of patients with PTMC was older than that of PTC (d>lcm). Male patients and patients with tumor d>5mm were more likely to have lymph node metastasis. The accuracy of frozen section examination in patients with PTMC was low.