| Objective:To improve the diagnosis and treatment of papillary thyroid carcinoma and reduce the misdiagnosis,this research mainly analyzes the clinical and pathological features of papillary thyroid carcinoma coexistent with other thyroid diseases and Papillary thyroid micro-carcinoma. At the same time,the study will provide some clinical clues for the relationship between papillary thyroid carcinoma and other thyroid diseases.Materials and methods:A retrospective hospital record study, which enrolled 1218 patients of thyroid carcinoma(thyroid surgery, head and neck radiotherapy, 131 I treatment, and cases of metastatic carcinoma of the thyroid gland have been ruled out), who underwent thyroid surgery and confirmed by pathology at the internal medicine department of the Bethune First Hospital of Jilin University from November 2014 to June 2015.Patient’s information was recorded in detail,such as age, sex, 131 I treatment,history,history of disease(hyperthyroidism, hypothyroidism),fine needle aspiration cytology,intraoperative frozen pathological examination,Histopathological results(the maximum diameter, the Number and location of cancer, capsule invasion,clinical st age, lymph node metastasis) and thyroid function tests(TSH, FT3,FT4, TPO-Ab, TG-Ab).Three pathological types, which are the largest proportion of papillary carcinoma, were divided into pure papillary thyroid carcinoma, papillary thyroid carcinoma coexistent with NG, papillary thyroid carcinoma coexistent with HT. According to the largest diameter of the papillary carcinoma,all papillary carcinoma were divided into: papillary thyroid micro-carcinoma and non papillary thyroid micro-carcinoma. SPSS 17.0statistics software was used for data analysis.Results:(1) The average age, gender, the number of cancer foci(single focus,multiple foci), and the location of cancer(unilateral or bilateral) were significantly different in three groups(P < 0.01). 1) Compared group 2 with group 1, there were significant differences(p< 0.01) that the average age on onset was larger and the proportion of multiple foci was lower. 2) Compared Group 3 with group 1, the incidence of female and bilateral carcinoma were higher, there was a significant difference(p< 0.01). 3) Group 3 compared with group 2, the incidence of female, multiple tumor, and bilateral carcinoma were higher, the average age of onset was younger, there was a significant difference(p< 0.01).(2) The TNM stage distribution were significantly different in three groups(P < 0.01),there was also significant difference between Group 2 and group 3.Group 1 Compared with group 2 and group 3, there was no significant difference in TNM stage distribution(P > 0.017).(3)The levels of TPO-Ab, TG-Ab, TSH and FT3 levels in the three groups were different(P < 0.05), and there were significant differences in TPO-Ab,TG-Ab and TSH levels(P < 0.01).(1) The levels of TPO-Ab and TG-Ab between group 1 and group 2 were different(P < 0.017), and the levels of TPOAb between the two groups were significantly different(P < 0.01).(2) The levels of TPO-Ab, TSH, FT3 and TG-Ab were significantly different between group 1 and group 3(P < 0.01).(3) The levels of TPO-Ab, TSH and TG-Ab between group 2 and group 3 were significantly different(P < 0.01).(4)Compared papillary thyroid micro-carcinoma with non Papillary thyroid micro-carcinoma : female patients were more common, average age of onset was older, multifocal and bilateral carcinoma accounteds for less proportion,Capsular invasion and lymph node metastasis were less.The false negative rate of fast frozen pathological examination was larger. The difference was statistically significant(P < 0.05). Compared with non Papillary thyroid microcarcinoma, the clinical stage of papillary thyroid micro-carcinoma was earlier,the difference was statistically significant(P < 0.01).Conclusions:(1) Compared with pure papillary thyroid carcinoma, Papillary thyroid carcinoma coexistent with HT has the following characteristics: female patients were more common, the proportion of multiple lesions and bilateral carcinoma were higher.The levels of TSH, TG-Ab and TPO-Ab in blood were higher, and the level of FT3 was lower.(2) Compared with pure papillary thyroid carcinoma, Papillary thyroid carcinoma coexistent with NG has the following characteristics: The average age of onset was older, the proportion of multiple foci carcinoma was lower,and the levels of TG-Ab and TPO-Ab were lower.(3) Compared with apillary thyroid carcinoma coexistent with NG,papillary thyroid carcinoma coexistent with HT has the following characteristics: Young women were more common,the proportion of multiple lesions and bilateral carcinoma were higher, clinical stage is earlier. The levels of TSH, TG-Ab and TPO-Ab in blood were higher.(4) Compared with non Papillary thyroid micro-carcinoma, papillary thyroid micro-carcinoma has the following characteristics: female patients were more common, the average age of onset was older, the proportion of multiple lesions and bilateral carcinoma were lower,capsule invasion and lymph node metastasis were less, clinical staging was earlier. In fast frozen pathological examination the probability of false negative was larger. |
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