Pattern and Treatment of Papillary Thyroid Carcinoma with Cervical Lymph Node Metastasis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cervical lymph node metastasis develops in approximately 30% to 80% of patients with papillary thyroid carcinoma. In papillary thyroid carcinoma, lymph node metastasis at presentation do not seem to adversely affect survival, but do increase the risk of loco-regional recurrence. The management of cervical metastasis in thyroid papillary carcinoma ranges from selective removal to a formal comprehensive neck dissection. In this study, we analyzed the pattern of cervical lymph node metastasis and the impact of prognostic variables in oder to plan how to manage the cervical lymph node metastasis in patients with papillary thyroid carcinoma. SUBJECTS AND METHOD: The clinical records and pathological reports of 114 patients who underwent surgery for thyroid papillary carcinoma at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university from 1996 to 2002 were analyzed retrospectively. RESULTS: Cervical nodal metastasis was found in 57 (50.0%) patients. Occult metastasis was found in 26 (22.8%) patients. Cervical lymph node metastasis was most frequently noted in the level VI (38.6%). The size of primary tumor and extrathyroidal invasion were associated with cervical metastasis. CONCLUSION: Based on our results, it might be suggested that elective central neck dissection is needed for patients with papillary thyroid carcinoma which is larger than 35mm or has extrathyriodal extension.

Angiogenesis and Ki67 Expression in the Thyroid Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Angiogenesis is the process of new blood vessel development from preexisting vessel. In many human solid tumor, the extent of angiogenesis is one of the most significant prognostic factors that can be used to predict the patient survival rate and metastasis. The aim of this study is to investigate the role of new blood vessel formation in the thyroid tumors. SUBJECTS AND METHOD: We analyzed the microvascular density and proliferation index in the 70 cases of thyroid tumors by double immunohistochemistry with anti-CD34 and anti-Ki67 antibody. The microvascular density and Ki67 index were compared with the clinical parameters such as sex, age, stage, tumor extension, cervical lymph node metastasis, and prognostic factors, which were obtained through the retrospective review of the medical records. RESULTS: The microvascular density and Ki67 index were higher in malignant tumors than in benign tumors. Higher microvascular density and Ki67 index were associated with tumor stage and increased risk of AMES, AGES and MACIS scores. CONCLUSION: The microvascular density and Ki67 index may serve as significant prognostic factors in the differentiated thyroid cancer.