ObjectiveTo explore the role of preoperative evaluation indicators for decision-making on treatment modalities in papillary thyroid microcarcinoma (PTMC) with intermediate- and high-risk. MethodThe recent pertinent literatures on studies of risk factors influencing PTMC were collected and reviewed. ResultsThe surgical treatment was advocated for the PTMC with intermediate- and high-risk. However, the intraoperative surgical resection range and the postoperative prognosis of patients were debated. The malignancy of cell puncture pathology was a key factor in determining the surgical protocol. The patients with less than 45 years old at surgery, male, higher body mass index, higher serum thyrotropin level, and multifocal and isthmic tumors, and nodule internal hypoecho, calcification, unclear boundary, and irregular morphology by ultrasound, as well as mutations in BRAFV600E and telomerase reverse transcriptase gene were the risk factors for preoperative evaluation of PTMC with intermediate- and high-risk. ConclusionsAccording to a comprehensive understanding of preoperative risk factors for PTMC with intermediate- and high-risk, it is convenient to conduct an accurate preoperative evaluation and fully grasp the patients’ conditions. Clinicians should formulate individualized surgical treatment plans for patients based on preoperative assessment and their own clinical experiences.
ObjectiveTo summarize the characteristics of cervical lymph node metastasis (LNM) in the papillary thyroid carcinoma (PTC) coexisting with Hashimoto thyroiditis (HT). MethodThe literatures related to cervical LNM of PTC coexisting with HT in recent years were collected and summarized. ResultsCompared with the PTC patients without HT, the more enlarged lymph nodes could be detected, and the cervival central LNM rate was lower, but there was still controversy about cervival lateral LNM in the patients with PTC coexisting with HT. The male, young, large tumor diameter, extraglandular invasion, multifocal cancer, BRAF gene mutation, and higher thyroid peroxidase antibody and thyroglobulin antibody levels, as well as the ultrasound features such as thyroid nodule aspect ratio >1, extremely low echo, calcification, and lymph node calcification, liquefaction, and disappearance of hilar lymph nodes could be used to evaluate the risk factors of cervical LNM for the patients with PTC coexisting with HT. ConclusionsFrom the results of this review, it is suggests that the rate of central LNM is lower in patients with PTC coexisting with HT, but the status of LNM in the cervical lateral region remains to be explored. The relevant risk factors in combination with ultrasonic characteristics could help evaluate cervical lymph node status, could provide basis for early detection of metastatic lymph nodes and the formulation of individualized surgical plans, and improve the prognosis of patients.