摘要目的：探讨甲状腺微小乳头状癌的临床病理特征及其生物学行为与预后的关系。方法收集2012至2014年254例（男性55例，女性199例）甲状腺微小乳头状癌的病理资料，对蜡块行免疫组织化学标记，镜下观察，结合B超影像学特征，对结果进行统计分析。结果甲状腺微小乳头状癌好发于女性，发病年龄集中在41～50岁，占43．3％（110／254）。 B超下表现低回声结节，多伴有钙化。肿瘤病灶直径≥0．5～1．0 cm，占病例数67．3％（171／254），该组易于颈部淋巴结转移，同时该组多发生在41岁以上年龄组中，差异具有统计学意义（ P＜0．05）。免疫组织化学标记CK19、Galectin－3和甲状腺转录因子－1等可以明确诊断。39．4％（100／254）的病例有桥本甲状腺炎的病史。结论甲状腺微小乳头状癌好发于女性，发病年龄集中在41～50岁；直径≥0．5～1．0 cm较易颈部淋巴结转移，但预后良好。桥本甲状腺炎与甲状腺乳头状癌的发生发展关系存在不确定性。

abstractsObjective To evaluate the prognostic impact of tumor size, ultrasonography, central neck lymph node involvement, and age of patients in papillary thyroid microcarcinoma ( PTMC) .Methods Two hundred and fifty-four patients who underwent total thyroidectomy and central neck dissection for PTMC between 2012 and 2014 were included in this retrospective study.Statistical correlation between tumor size and various clinicopathological parameters was assessed by univariate and multivariate analyses. The ultrasound findings were also evaluated.Results A total of 254 patients (199 females and 55 males) were included in this study.PTMC showed a predilection for female patients, 41-50 years of age (43.3%of all cases, 110/254), and ultrasound showed hypoechoic nodules.Statistically significant correlation was demonstrated between central neck lymph node involvement and the following factors:age and tumor size.A tumor diameter greater than 0.5 mm (67.3%of all cases) most commonly occurred in patients older than 41 years, and was associated with a higher risk of metastatic central neck lymph node involvement (P<0.05). Hashimoto′s thyroiditis was noted in the background in 39.4%( 100/254 ) of cases.Conclusions Tumor size appears to have a prognostic impact in PTMC, and larger size is more likely to be associated with a higher risk of central neck lymph node involvement.It is controversial whether the etiology of papillary thyroid carcinoma is related to Hashimoto′s thyroiditis.