TİROİD PAPİLLER KANSERİNDE MULTİFOKALİTE İLE İLİŞKİLİ FAKTÖRLER: 186 OLGUNUN ANALİZİ

Amaç: Papiller tiroid kanseri (PTK) tiroid malignitelerinin en sık görülen tipidir ve tüm tiroidkanserlerinin %70-80’ini oluşturmaktadır. Çalışmamızın amacı PTK’nde multifokalite ile ilişkilifaktörleri araştırmaktır.Yöntem: Kliniğimizde Mayıs 2005 - Temmuz 2009 tarihleri arasında tiroidektomi yapılan vePTK saptanan olgular multifokaliteyi etkileyen faktörler yönünden olgu dosyası ve bilgisayarhasta kayıt sisteminde geriye dönük incelendi. Bulgular: Çalışma kriterlerimize uyan 26 kadın 160 erkek toplam 186 olgu dahil edildi.Patolojik incelemede 67 (%36) olguda tek nodül, 119 (%64) olguda multinodülarite bulundu.PTK 137 (%73.6) olguda unifokal, 49 (%26.4) olguda multifokal idi. Tümör çapı 103 (%55.4)olguda 1 cm’in altında, 83 (%44.6) olguda 1 cm ve üstü olarak bulundu. Tümör çaplarının 0,54 cm (ort:1.78, SD:1.1) arasında değiştiği görüldü. Multinodülarite saptanan 119 olgunun49’unda (%41.1) multifokalite bulunurken tek nodül olan 67 olgunun hiçbirisinde multifokalitebulunmadı (P:0.001) . Yaş grupları ve cinsiyet ile fokalite arasında istatistiksel olarak anlamlıfarklılık mevcut degildi (sırasıyla P:0.9, ve 0.44) .Sonuç: Çalışmamızda tümör boyutunun, cinsiyetin, nodül boyutunun, seçilen operasyon tipinin,kapsül ve vasküler invazyonun multifokaliteyi etkilemediğini; etkileyen en önemli ve tekfaktörün multinodülarite olduğu saptanmıştır. Bu yüzden preoperatif dönemde tanı koyulabilenmultinodüler PTK olgularında multifokalite olasılığı için total tiroidektomi yapılması gerektiğinidüşünmekteyiz

Anahtar Kelimeler:

Papiller tiroid kanseri, multifokalite, tiroid cerrahisi

Factors Related to Multifocality in Papillary Thyroid Cancer: Analysis of 186 Cases

Objective: Papillary thyroid cancer (PTC) is the most common type of thyroid cancer, and itaccounts for 70-80% of all malignancies of the thyroid gland. The aim of the present study wasto investigate the factors associated with multifocality in PTC.Materials and Methods: The medical records of the patients (patient charts, computerizedpatient registry), who underwent thyroidectomy in our clinics between May 2005 and July 2009and who were found to have PTC, were retrospectively reviewed for the factors affectingmultifocality.Results: A total of 186 cases (26 females [14%] and 160 males [86%]) were included in thestudy. The histopathological examination revealed a single nodule in 67 cases (36%) andmultiple nodules in 119 cases (64%). PTC was unifocal in 137 cases (73.6%) and multifocal in49 cases (26.4%). The tumor diameter was smaller than 1 cm in 103 patients (55.4%) and at orabove 1 cm in 83 patients (44.6%). The tumor diameter range was 0,5-4 cm (M:1,78, SD:1,1).Of 119 patients who were found to have multiple nodules, 49 (41.1%) were found to havemultifocality, and the remaining 67 patients with single nodule did not have any multifocality.There were no significant statistical analysis between age and gender about multifocality. Conclusion: The present study showed that tumor size, gender, nodule size, selected operationtype, capsule, and vascular invasion did not affect multifocality, and the presence of multiplenodules was the most single important factor affecting multifocality. Therefore, the authorssuggest that total thyroidectomy should be performed in patients with multinodular PTCdiagnosed preoperatively due to the possibility of multifocality

Keywords:

Papillary thyroid cancer, multifocality, thyroid surgery,

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