Thyroid microcarcinoma(TMC) refers to the diameter less than 1cm in thyroid cancer. In recent years, with high frequency ultrasound and pathology diagnosis technology development and improvement, the incidence of TMC increased dramatically. However, there are a lot of controversy about its complication, treatment methods and value of treatment both in domestic and abroad. In this paper,we review literatures in the passed 5 years both in domestic and abroad, and investigated the progress of treatment for TMC. Agreement on the view: routine central lymph node dissection should be done regularly in the treatment thyroid microcarcinoma.
Humans ; Thyroid Neoplasms ; surgery ; therapy

OBJECTIVE: The purpose of this study was to discuss the role of the combination of carbon nanoparticles and medical imaging to manage the cervical lymph nodes in patients with thyroid carcinoma. METHOD: Eighty one patients with thyroid carcinoma that primary treated were divided into two groups: trial group and control group. Carbon nanoparticles were injected into the thyroid gland of trial group patients. Central compartment (level VI) dissection, levels IIl and IV dissection, lateral node (levels II-V) dissection were performed respectively in all the patients on the basis of medical imaging and pathology. Total lymph nodes, metastasis lymph nodes, black stained lymph nodes and black stained metastasis lymph nodes of trial group were counted respectively in different dissection specimens. Total lymph nodes and metastasis lymph nodes of control group were counted respectively in different dissection specimens. Parathyroid glands of thyroid or central compartment dissection specimens were counted in two groups. RESULT: In trial group, rate of staining lymph node was 80.0% in central neck dissection tissue, 54.9% in levels III and IV dissection specimen, 39.1% in lateral node dissection specimen. In central compartment dissection tissue, lymph nodes on average in control group were less than in trial group (3.03 ± 2.07 vs. 4.72 ± 2.97) (P < 0.01). The same was in levels III and lV dissection specimen (5.53 ± 3.78 vs. 10.29 ± 3.36) (P < 0.01). As for lateral node dissection specimen,there was no statistic difference in the two group (13.4 ± 9.67 vs. 14.56 ± 6.28) (P > 0.05). There was no statistic difference between control group and trial group for the metastasis lymph nodes in difference dissection specimens. Parathyroid gland was found in 3 thyroid or central compartment dissection specimens among trial group, which was found in 9 specimens among control group, the difference had statistical significance (P < 0.05). CONCLUSION During levels III and IV dissection in cN0 patients or central compartment dissection, lymph nodes can be signed well by carbon nanoparticles, which can improve the lymph node detection rate, but can not increase the lymph node detection rate in cN+ patients. Parathyroid gland can be preserved by carbon nanoparticles during the thyroid gland resection and central neck dissection.
Carbon ; administration & dosage ; Diagnostic Imaging ; methods ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Nanoparticles ; administration & dosage ; Neck ; Neck Dissection ; methods ; Parathyroid Glands ; Staining and Labeling ; Thyroid Neoplasms ; diagnosis ; pathology ; Thyroidectomy

OBJECTIVE: To evaluate the role of the combination of ultrasound and enhanced CT in analyzing lymph node metastasis in thyroid papillary carcinoma (PTC) patients by compartment. METHOD: Clinical data of 115 cases (141 sides) with PTC were collected. All had undergone ultrasound in neck and enhanced CT both in neck and in mediastinum before surgery. They were divided into ultrasound group. CT group, and the combination of ultrasound and enhanced CT group to evaluate lymph node metastasis. RESULT: For the central compartment, the accuracy of ultrasound was 61.0%. CT was 48.9%, and the combination of ultrasound and CT was 62.4%. For the lateral compartment, ultrasound was 87.9%, CT was 78.7%, the combination of ultrasound and CT was 85.8%. Ultrasound had higher accuracy than CT in the central (P < 0.05) and lateral (P < 0.05) compartment. The combination of ultrasound and CT had higher accuracy than CT in the central compartment (P < 0.05), but there was no significant difference in the lateral compartment (P > 0.05). There was no significant difference in accuracy between ultrasound and the combination of ultrasound and CT neither in central (P > 0.05) nor in lateral (P > 0.05) compartment. Six cases of lymph node metastasis in mediastinum and 1 case in parapharyngeal space detected by CT were pathologically proven. CT found that five patients with pulmonary metastasis. CONCLUSION The combination of ultrasound and CT or single ultrasound has higher accuracy in preoperative evaluation than single CT for lymph node metastasis in PTC. CT can assess some compartments such as mediastinum which can't be detected by ultrasound, and at the same time to evaluate lung metastasis. To evaluate lymph node metastasis in PTC, the combination of ultrasound and CT is more accurate and considerate than single method.
Adolescent ; Adult ; Aged ; Carcinoma ; diagnostic imaging ; pathology ; Carcinoma, Papillary ; Child ; Female ; Humans ; Lymphatic Metastasis ; diagnostic imaging ; Male ; Middle Aged ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color ; Young Adult