| Objective:As multiple focuses is the common character of endocrine tumors, it is essentially the same to multifocal papillary thyroid carcinoma (MPTC). It is reported that multiple focuses is related to the metastasis and prognosis of thyroid cancer. This study aimed to investigate the structure and clinical characteristics of MPTC, providing a theoretical basis for the diagnosis and treatment of MPTC.Methods:404cases of PTC who underwent thyroid surgery and were diagnosed pathologically in Shandong Provincial Hospital from January 2012 to December 2013 were collected. They were divided into two groups,multifocal group and single focal group,according to the number of lesions.SPSS 19.0 statistical software were used for data analysis.Results:There were 145 cases in multifocal group,accounting for 35.9% of all PTC cases in the same period.The mean age of multifocal group was 41.72 years old vs 44.56 years old of single focal group (T-test P=0.23).Occurrence rate of calcification in ultrasound images was higher in multifocal group(85.5%) than in single focal group(59.5%),(χ2=29.411,P=0.000);There was a higher ratio of male in multifocal group(22.1%) than in single focal group(8.9%),(χ2 =13.749,P=0.000);Compared to the single focal group, multifocal group has the higher rate of lymph node metastasis(50.3% vs 31.7%), (χ2=13.724,P=0.000); local invasion rate of multifocal group was 29.7%,higher than that of the ingle focal group (12.4%) (χ2=18.403,P=0.000);The rate of cases who had PTC combined with Nodular Goiter was38.6% in multifocal group, which was lower than that in single focal group(43.6%), (χ2=0.958,P=0.328); The rate of cases who had PTC combined with Hashimoto’s Thyroiditis was29.7% in multifocal group, which was lower than that in single focal group(30.9%), (χ2=0.067,P=0.796);The microcarcinoma rate of multifocal group(46.9%) was lower than that in single focal group(55.2%),χ2= 2.576,P=0.108).All 404 cases of PTC patients, whether or not combined with Nodular Goiter and Hashimoto’s thyroiditis had no significant effect on the rate of lymph node metastasis.56.9% of the multifocal group had more than two lesions while 43.1% of them had just two lesions. Lesions of 47 cases(32.4%)were unilateral and 98 cases(67.6%)were bilateral. The microcarcinoma ones(46.9%) of multifocal group had a much lower lymph node metastasis rate than the non-microcarcinoma ones(χ2= 7.556,P=0.006). Lesions were unilateral or bilateral and the number of lesions in MPTC group had no significant impact on lymph node metastasis rate.Conclusions:Among the MPTC patients, calcification rate was higher in multifocal group than that in single focal group. There was a higher ratio of male in multifocal group, therefore, in the diagnosis and treatment of male patients with PTC, more attentions should be paid in order to avoid misdiagnosis. For multifocal group had significantly higher local invasion rate and lymph node metastasis rate, central compartment nodal dissection was advised even when lymph node metastasis was not found in preoperative clinical examinations. In addition, the affect of age, tumor size, Nodular Goiter and Hashimoto’s thyroiditis on the incidence of MPTC had no statistical significance.MPTC patients with more than two lesions was the majority and the rate of tumors located bilateral was higher than unilateral ones, but none of them had significant impact on lymph node metastasis rate. Lesions whose diameter was greater than 1cm had significantly higher rate of lymph node metastasis than those less than lcm in diameter. |
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