Background: The accurate preoperative diagnosis of TC plays a very important role in the selection of an appropriate treatment strategy. In addition to the hypoechogenicity of thyroid lesions on ultrasound and the presence of microcalcifications or high cell atypia on FNAB, highlighting the features of laterality and focality and ascertaining their influence (alone or combined) on TC staging and appropriate treatment are crucial. Materials and Methods: A retrospective analysis of the clinical data of 697 patients admitted to the study center between 2008 and 2023 was conducted. Preoperative data (age, sex, type of surgery, ultrasound, and FNAB data) and postoperative histopathological data indicating TC advancement (pTNM, extrathyroidal extension, vascular invasion) were collected and analyzed. Patients presenting well-differentiated TCs (papillary TC and follicular TC) were isolated for better clinical evaluation. Finally, patients were divided into four groups according to their laterality and focality features, and the influences of combinations of these features on TC advancement were analyzed. Results: The largest group included patients with unilateral and solitary TC (n= 461). This group had the lowest rate of negative prognostic features: extrathyroidal extension, lymph node invasion, distant metastases, and vascular invasion (25.81%, 19.96%, 3.69%, and 26.46%, respectively). In contrast, the group with bilateral and multifocal TC (n= 40) presented the highest percentages of the mentioned features (82.50%, 82.50%, 7.50%, and 77.50%, respectively). All the results were statistically significant (p< 0.0001). Conclusions: Laterality and focality features may be important parameters in the management of TC and should be accurately determined. These features should be combined and a more aggressive treatment method should be selected to reduce the reoperation rate.
背景：甲状腺癌（TC）的准确术前诊断对选择恰当的治疗策略至关重要。除超声检查中甲状腺病变的低回声性、细针穿刺活检（FNAB）中微钙化或高度细胞异型性的存在外，明确病灶的侧向性和局灶性特征，并确定其（单独或联合）对TC分期及适宜治疗方案的影响具有关键意义。材料与方法：对2008年至2023年间研究中心收治的697例患者的临床资料进行回顾性分析。收集并分析术前数据（年龄、性别、手术类型、超声及FNAB结果）以及提示TC进展的术后组织病理学数据（pTNM分期、甲状腺外侵犯、血管侵犯）。为便于临床评估，将分化型TC（乳头状TC与滤泡状TC）患者单独分组。最终根据病灶侧向性与局灶性特征将患者分为四组，分析这些特征组合对TC进展的影响。结果：最大组为单侧单灶TC患者（n=461），该组不良预后特征发生率最低：甲状腺外侵犯、淋巴结转移、远处转移及血管侵犯的发生率分别为25.81%、19.96%、3.69%和26.46%。与之相反，双侧多灶TC组（n=40）上述特征发生率最高（分别为82.50%、82.50%、7.50%和77.50%）。所有结果均具有统计学显著性（p<0.0001）。结论：侧向性与局灶性特征可作为TC诊疗管理的重要参数，应予准确判定。应综合评估这些特征并选择更积极的治疗方案，以降低再手术率。
肿瘤(癌症)患者之家