组织学参数驱动完成甲状腺切除术在一个大体积机构的乳头甲状腺癌:一个回顾性观察性研究研究
Leonardo Rossi1, Andrea De Palma1, Carlo Enrico Ambrosini1
1Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
American journal of surgery
|October 22, 2024
概括
在最初的甲状腺叶切除术后,对于乳头性甲状腺癌 (PTC),侵略性组织学特征,如较大的瘤大小,侵略性变体和血管入侵,强烈预测需要完成甲状腺切除术 (CT). 瘤大小超过21毫米或两个攻击性因素表明CT.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 在最初的甲状腺叶切除术后,乳头甲状腺癌 (PTC) 的管理缺乏关于完成甲状腺切除术 (CT) 的共识.
- 组织学发现至关重要,但需要明确的指导方针来做出CT决定.
- 这项研究调查了影响CT必要性的特定组织学参数.
研究的目的:
- 确定关键的组织学特征,以指导在乳头甲状腺癌患者中完成甲状腺切除术的决定.
- 建立客观的标准进行CT基于病理的发现后切除术.
主要方法:
- 对426名经过甲状腺叶切除术 (2019-2022) 的乳头甲状腺癌患者的回顾性分析.
- 患者被分为两组:没有接受CT的患者 (A组) 和接受CT的患者 (B组).
- 组织学参数在各组之间进行了比较,多变量和ROC曲线分析用于确定CT的预测因素.
主要成果:
- 完成甲状腺切除术 (CT) 在31.7%的患者 (135/426) 中进行.
- 多变量分析显示CT和瘤大小 (p < 0.001),攻击性变体 (p = 0.009) 和血管入侵 (p < 0.001) 之间存在显著的关联.
- 在ROC分析中,发现瘤大小切线为21毫米,以及推CT的2个侵略性因素的门.
结论:
- 瘤大小,侵袭性组织学变异和血管入侵是决定 papillary thyroid carcinoma 完成甲状腺切除术的关键因素.
- 在最初的甲状腺叶切除术后,具有侵略性特征的患者必须进行全面的病理评估.
- 对瘤大小和侵略性因素的确定的切断值可以帮助CT的临床决策.
相关概念视频
The Thyroid Gland
7.1K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
7.1K
Hyperthyroidism II: Pathophysiology
58
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
58


