Diagnóstico incidental versus clínico del microcarcinoma papilar de tiroides. Pronóstico a largo plazo / Incidental versus clinical diagnosis of papillary thyroid microcarcinoma. Long-term prognosis
Endocrinol. diabetes nutr. (Ed. impr.)
; 67(5): 317-325, mayo 2020. tab
Artigo
em Espanhol
| IBECS
| ID: ibc-191307
Biblioteca responsável:
ES1.1
Localização: BNCS
RESUMEN
INTRODUCCIÓN:
La incidencia del microcarcinoma papilar de tiroides (MCPT) está aumentando en los últimos años, especialmente en pacientes intervenidos por enfermedad tiroidea presumiblemente benigna. El objetivo de este estudio es analizar las diferencias entre el MCPT de diagnóstico incidental y de diagnóstico clínico preoperatorio, así como su pronóstico a largo plazo. MATERIAL YMÉTODOS:
La población a estudio la constituyen los pacientes con diagnóstico histológico de MCPT. Se excluyeron los pacientes con cirugía tiroidea previa, con otras enfermedades tiroideas o extratiroideas malignas sincrónicas y localización ectópica del MCPT. Se compararon 2 grupos pacientes con diagnóstico incidental (grupo 1) y con diagnóstico clínico (grupo 2). Se realizó un análisis multivariante de los factores diferenciadores.RESULTADOS:
El MCPT de diagnóstico clínico presentó mayor frecuencia de hipotiroidismo (4,6% vs.18,9%; p = 0,004), invasión extracapsular (5,7% vs.17,6%; p = 0,018), adenopatías metastásicas (1,1% vs.18,9%; p < 0,001) y tiroiditis linfocitaria (5,7% vs.27%; p < 0,001). En el análisis multivariante la presencia de adenopatías metastásicas (OR 22,011; IC 95% 2,621-184,829; p = 0,004) y la tiroiditis linfocitaria (OR 4,949; IC 95% 1,602-15,288; p = 0,005) se asociaron con el diagnóstico clínico del MCPT. Durante un seguimiento medio de 119,8 ± 65,1 meses se detectó una recidiva en el grupo 2 (0 vs.1,4%; p = 0,460). Ningún paciente falleció debido a la enfermedad.CONCLUSIONES:
El MCPT de diagnóstico clínico, aunque presenta características histopatológicas más agresivas (invasión extracapsular y de adenopatías metastásicas), su pronóstico a largo plazo es similar al MCPT incidental. La presencia de adenopatías metastásicas y tiroiditis linfocitaria fueron factores independientes asociados al MCPT de diagnóstico clínicoABSTRACT
INTRODUCTION:
The incidence of papillary thyroid microcarcinoma (PTMC) has increased in recent years, especially in patients operated on for presumably benign thyroid disease. The aim of this study was to analyze the differences between PTMC incidentally diagnosed and PTMC clinically diagnosed, as well as its long-term prognosis. MATERIAL ANDMETHODS:
The study population consisted of patients with a histological diagnosis of PTMC. Patients with previous thyroid surgery, other synchronous thyroid or extrathyroid malignancies and an ectopic location of PTMC were excluded. Two groups were compared patients with PTMC incidentally diagnosed (group 1) and patients with PTMC clinically diagnosed (group 2). A multivariate analysis of differentiating factors was performed.RESULTS:
PTMC clinically diagnosed had a high frequency of hypothyroidism (4.6% vs.18.9%; P = .004), extrathyroidal extension (5.7% vs.17.6%; P = .018), metastatic lymph nodes (1.1% vs.18.9%; P < .001) and lymphocytic thyroiditis (5.7% vs.27%; P < .001). In the multivariate analysis, metastatic lymph nodes (OR 22.011, IC 95% 2.621-184.829; P = .004) and lymphocytic thyroiditis (OR 4.949; IC 95% 1.602-15.288; P = .005) were associated with the clinical diagnosis of PTMC. During a mean follow-up of 119.8 ± 65.1 months, one recurrence was detected in group 2 (0% vs.1,4%; P = .460). No patient died due to the disease.CONCLUSIONS:
PTMC clinically diagnosed, although it has more aggressive histopathological characteristics (extrathyroidal extension and metastatic lymph nodes), presents a long-term prognosis similar to the PTMC incidentally diagnosed. The presence of metastatic lymph nodes and lymphocytic thyroiditis were independent factors associated with PTMC clinically diagnosed
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Coleções:
Bases de dados nacionais
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Espanha
Base de dados:
IBECS
Assunto principal:
Prognóstico
/
Achados Incidentais
/
Câncer Papilífero da Tireoide
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Endocrinol. diabetes nutr. (Ed. impr.)
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Clínico Universitario Virgen de la Arrixaca/España
/
Universidad de Murcia/España