Feasibility of active surveillance for multifocal papillary thyroid microcarcinoma
10.3760/cma.j.cn115624-20241106-00888
- VernacularTitle:多灶性甲状腺微小乳头状癌进行主动监测的可行性探讨
- Author:
Guangxiang YANG
1
;
Rong WANG
;
Yue LIU
Author Information
1. 大连大学附属中山医院健康管理中心，大连 116001
- Publication Type:Journal Article
- Keywords:
Multifocality;
Papillary thyroid microcarcinoma;
Active surveillance;
Progression
- From:
Chinese Journal of Health Management
2025;19(2):106-111
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility of active surveillance for multifocal papillary thyroid microcarcinoma(PTMC).Methods:It was a cross-sectional study. The thyroid ultrasonography data from 124 580 health check-up participants in the Health Management Center at the Affiliated Zhongshan Hospital of Dalian University between March 2017 and December 2023 were retrospectively analyzed. The patients were divided into unifocal or multifocal group according to the number of PTMC. The rates of growth, lymph node metastasis and progression in the unifocal and multifocal PTMC group during active surveillance were compared by using the Kaplan-Meier method and the log-rank test. The patients were divided into the group of progression or no-progression according to the outcome of active surveillance, and the basic clinical characteristics between the groups were compared. The Cox proportional hazards regression analysis was used to identify the risk factors for the progression of PTMC.Results:A total of 304 patients were enrolled in this study, among them, there were 239 cases of unifocal PTMC and 65 cases of multifocal PTMC. There was no significant differences in the rates of growth, lymph node metastasis and progression in the PTMC between the two groups during active surveillance (all P>0.05). During the active surveillance period, a total of 47 cases of PTMC progressed, while 257 cases did not. The progression rate was 15.5%. There was statistically significant difference in the initial age of PTMC diagnosis between the progression and non-progression group ( P<0.05). Multivariate regression analysis showed that age of initial diagnosis was the only risk factor for the progression of PTMC, the risk of progression decreased by 0.079 for every one-year increase in the initial diagnosis age [ HR=0.921, (95% CI: 0.888-0.955), P<0.001], multifocality was not a risk factor[ HR=1.973, 95% CI(0.972-4.462), P=0.103]. Conclusion:Active surveillance can be performed for multifocal PTMC in patients of appropriate age.
