Papillary Thyroid Carcinoma: Analysis of the Size of the Primary Tumor, Infiltration of the Thyroid Capsule and Lymfangioinvasiona Due to Metastatic Involvment of Regional Lymph Nodes and Age


Authors: M. Sičák 1;  J. Sojak 1,2;  M. Slašťan 3;  A. Kališ 4
Authors‘ workplace: Slovenská zdravotnícka univerzita v Bratislave, Katolícka univerzita v Ružomberku, Klinika otorinolaryngológie a chirurgie hlavy a krku, Ústredná vojenská nemocnica – Fakultná nemocnica v Ružomberku 1;  Univerzita Komenského v Bratislave, Jesseniova lekárska fakulta v Martine, Ústav patologickej fyziologie 2;  Univerzita Komenského v Bratislave, Jesseniova lekárska fakulta v Martine, Ústav lekárskej biochemie 3;  Katolícka univerzita v Ružomberku, Ústav patologickej anatómie, Ústredná vojenská nemocnica – Fakultná nemocnica v Ružomberku 4
Published in: Otorinolaryng. a Foniat. /Prague/, 62, 2016, No. 4, pp. 224-231.
Category: Original Papers

Overview

Introduction:
In patients with papillary carcinoma of thyroid gland TNM classification is used to asses clinical stage, with age of 45 years being one of the basic criteria. The aim of this study was to analyze the size of the primary tumor, capsule infiltration, invasion of regional lymphatic vessels, multifocal disability and metastatic involvement of regional lymph nodes of the neck with respect to the 45 year age limit.

Methods:
In a retrospective study we did a statistical analysis of a group of 336 patients suffering from papillary thyroid carcinoma. The group was divided into 135 patients under 45 years of age and 201 patients over 45 years of age.

Results:
When comparing the group of patients of age under 45 years and over 45 years we have found the metastatic involvement of cervical lymph nodes (N1) to be 54,1 % vs. 26,9 % of patients respectively, P<0.001 (P=0.000072) and multifocal involvement in 31,9% vs. 25,9 % of patients respectively , P<0.05 (P=0.025). In the group under 45 years we have found the size of the tumor to be ≥1cm significantly more often in the N1 subgroup, P<0.01 (P=0.0015). In patients older than 45 years there was no difference in size of tumor comparing N1 and N0 subgroups. In the group of patients under 45 years of age was statistically higher frequency of lymphangioinvasion in N1 subgroup, P<0.01 (P=0.0063). More frequent infiltration of the capsule of thyroid gland in the N1 subgroup was in both age groups, under 45 years P<0.001 (P=0.0000001) as well as in the group of over 45 years P<0.001 (P=0.0008).

Conclusion:
In the group of patients with papillary thyroid carcinoma under 45 years of age, compared to the group of patients over 45 years of age, we have noted significantly higher incidence of metastatic involvement of regional lymph nodes and multifocal involvement. In younger patients with N1 we noted higher lymphangioinvasion and tumor size over 10 mm.

Keywords:
papilary thyroid carcinoma, age , regional lymph nodes involvement, risk factors


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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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