{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:24:15Z","timestamp":1792686255815,"version":"4.5.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec011\">\n<jats:title>Aim<\/jats:title>\n<jats:p>Exploring the clinical differences between papillary thyroid micarcinoma (PTMC) and papillary thyroid carcinoma (PTC), optimizing clinical decision-making pathways, and reducing excessive medical behavior while ensuring therapeutic efficacy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec012\">\n<jats:title>Method<\/jats:title>\n<jats:p>Patients diagnosed with PTMC or PTC by pathological histology from May 2023 to May 2024 at Jinan Shizhong District People\u2019s Hospital were retrospectively analyzed. PTMC refers to thyroid papillary carcinoma with a maximum diameter of \u22641\u2009cm.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec013\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were 186 patients (PTMC group) whose maximum tumor diameter was\u2009\u2264\u20091\u2009cm and 45 patients (PTC group) whose maximum tumor diameter was\u2009&gt;\u20091\u2009cm. The patient\u2019s age was (45.97\u2009\u00b1\u200910.63) years for the PTMC group and (45.31\u2009\u00b1\u200911.55) years for the PTC group. No statistically significant differences existed between the two groups in sex, age, BRAF V600E gene mutation, tumor multifocality, and capsular invasion (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). Between the two groups, there were statistically significant (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) differences in TNM staging, the thyroid imaging reporting and data system (TI-RADS) staging, and cervical lymph node metastasis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec014\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Thyroid surgery, thermal ablation, and active monitoring are different approaches in the stratified treatment of PTMC and PTC. To avoid overtreatment and improve the quality of life of the patients, personalized treatment plans should be developed according to the test results of TNM stage, TI-RADS classification, and cervical lymph node metastasis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0327423","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T17:29:45Z","timestamp":1752082185000},"page":"e0327423","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Papillary thyroid microcarcinoma and papillary thyroid carcinoma: Clinical characteristics and stratification of treatment strategies"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9009-5925","authenticated-orcid":true,"given":"Congcong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9647-2077","authenticated-orcid":true,"given":"Xuewei","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"issue":"2","key":"pone.0327423.ref001","first-page":"70","article-title":"Clinical features of papillary thyroid carcinoma and risk factors related to cervical lymph node metastasis","volume":"31","author":"J Song","year":"2024","journal-title":"China Modern Med"},{"issue":"4","key":"pone.0327423.ref002","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1097\/JS9.0000000000001117","article-title":"Clinical and molecular features of progressive papillary thyroid microcarcinoma","volume":"110","author":"Z Wang","year":"2024","journal-title":"Int J Surg"},{"key":"pone.0327423.ref003","first-page":"5544232","article-title":"The overdiagnosis of thyroid micropapillary carcinoma: The rising incidence, inert biological behavior, and countermeasures","volume":"2021","author":"S Xu","year":"2021","journal-title":"J Oncol"},{"issue":"1","key":"pone.0327423.ref004","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ecl.2018.10.006","article-title":"Management of papillary thyroid microcarcinoma","volume":"48","author":"JP Brito","year":"2019","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"3","key":"pone.0327423.ref005","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1007\/s00268-015-3392-y","article-title":"Clinical trials of active surveillance of papillary microcarcinoma of the thyroid","volume":"40","author":"A Miyauchi","year":"2016","journal-title":"World J Surg"},{"key":"pone.0327423.ref006","doi-asserted-by":"crossref","first-page":"1359621","DOI":"10.3389\/fendo.2024.1359621","article-title":"Tumor growth manifested in two-fifths of low-risk papillary thyroid microcarcinoma patients during active surveillance: data from a tertiary center in China","volume":"15","author":"K Le","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"pone.0327423.ref007","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1089\/thy.2013.0527","article-title":"Papillary thyroid microcarcinoma might progress during pregnancy","volume":"24","author":"H Shindo","year":"2014","journal-title":"Thyroid"},{"issue":"2","key":"pone.0327423.ref008","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4183\/aeb.2023.163","article-title":"Papillary microcarcinoma of the thyroid gland - does size matter?","volume":"19","author":"R Dimov","year":"2023","journal-title":"Acta Endocrinol (Buchar)"},{"issue":"1","key":"pone.0327423.ref009","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1089\/thy.2017.0227","article-title":"Insights into the management of papillary microcarcinoma of the thyroid","volume":"28","author":"A Miyauchi","year":"2018","journal-title":"Thyroid"},{"key":"pone.0327423.ref010","first-page":"132","article-title":"The overtreatment of papillary thyroid microcarcinoma in the community","volume":"233","author":"PJ Abraham","year":"2024","journal-title":"Am J Surg"},{"issue":"1","key":"pone.0327423.ref011","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12957-019-1638-0","article-title":"Which papillary thyroid microcarcinoma should be treated as \u201ctrue cancer\u201d and which as \u201cprecancer\u201d?","volume":"17","author":"K Kaliszewski","year":"2019","journal-title":"World J Surg Oncol"},{"issue":"3","key":"pone.0327423.ref012","doi-asserted-by":"crossref","first-page":"203","DOI":"10.20892\/j.issn.2095-3941.2017.0051","article-title":"2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma","volume":"14","author":"M Gao","year":"2017","journal-title":"Cancer Biol Med"},{"issue":"2","key":"pone.0327423.ref013","doi-asserted-by":"crossref","DOI":"10.1634\/theoncologist.2020-0306","article-title":"Changes in stage distribution and disease-specific survival in differentiated thyroid cancer with transition to American Joint Committee on Cancer 8th Edition: a systematic review and meta-analysis","volume":"26","author":"MG Lechner","year":"2021","journal-title":"Oncologist"},{"issue":"1","key":"pone.0327423.ref014","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jcu.22772","article-title":"ACR TI-RADS: an advance in the management of thyroid nodules or Pandora\u2019s box of surveillance?","volume":"48","author":"JM Fradin","year":"2020","journal-title":"J Clin Ultrasound"},{"issue":"7","key":"pone.0327423.ref015","first-page":"139","article-title":"Thyroid ultrasonographic charasteristics and Bethesda results after FNAB","volume":"23","author":"E Triantafillou","year":"2018","journal-title":"J BUON"},{"key":"pone.0327423.ref016","doi-asserted-by":"crossref","first-page":"10732748231199647","DOI":"10.1177\/10732748231199647","article-title":"Clinical and pathological characteristics of patients with papillary thyroid carcinoma coexisting with Hashimoto\u2019s thyroiditis: a retrospective cohort study","volume":"30","author":"Y Yang","year":"2023","journal-title":"Cancer Control"},{"issue":"8","key":"pone.0327423.ref017","doi-asserted-by":"crossref","first-page":"7335","DOI":"10.3390\/curroncol30080532","article-title":"Prevalence of occult central lymph node metastasis by tumor size in papillary thyroid carcinoma: a systematic review and meta-analysis","volume":"30","author":"L Tang","year":"2023","journal-title":"Curr Oncol"},{"key":"pone.0327423.ref018","doi-asserted-by":"crossref","first-page":"4412725","DOI":"10.1155\/2022\/4412725","article-title":"The predictive value of ACR TI-RADS classification for central lymph node metastasis of papillary thyroid carcinoma: a retrospective study","volume":"2022","author":"M Zhong","year":"2022","journal-title":"Int J Endocrinol"},{"issue":"2","key":"pone.0327423.ref019","first-page":"120","article-title":"Clinicopathologic differences between micropapillary and papillary thyroid carcinoma","volume":"53","author":"K Kartal","year":"2019","journal-title":"Sisli Etfal Hastan Tip Bul"},{"issue":"1","key":"pone.0327423.ref020","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s00330-023-09908-2","article-title":"Ultrasound-guided microwave ablation versus surgery for solitary T1bN0M0 papillary thyroid carcinoma: a prospective multicenter study","volume":"34","author":"M-H Guo","year":"2024","journal-title":"Eur Radiol"},{"issue":"5","key":"pone.0327423.ref021","first-page":"548","article-title":"Analysis of traditional Chinese medicine syndromes and pathological characteristics of thyroid papillary carcinoma with Hashimoto\u2019s thyroiditis","volume":"41","author":"J Qiao","year":"2024","journal-title":"Tianjin J Traditional Chinese Med"},{"issue":"9","key":"pone.0327423.ref022","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1507\/endocrj.EJ22-0056","article-title":"Prognostic significance of patient age in papillary thyroid carcinoma with no high-risk features","volume":"69","author":"Y Ito","year":"2022","journal-title":"Endocrine J"},{"issue":"10","key":"pone.0327423.ref023","first-page":"405","article-title":"Chinese expert consensus on diagnosis and treatment of thyroid micropapillary cancer (2016 edition)","volume":"43","author":"Thyroid Cancer Professional Committee of China Anti Cancer Association (CATO)","year":"2016","journal-title":"Clin Oncol China"},{"issue":"8","key":"pone.0327423.ref024","first-page":"8","article-title":"Expert consensus on thermal ablation therapy for papillary thyroid cancer (2024 edition)","volume":"39","year":"2024","journal-title":"Chinese Med Information Guide"},{"issue":"7","key":"pone.0327423.ref025","article-title":"Active surveillance may be the best initial management for papillary thyroid microcarcinoma","volume":"7","author":"Y Ito","year":"2023","journal-title":"J Endocr Soc"},{"issue":"4","key":"pone.0327423.ref026","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1507\/endocrj.EJ22-0559","article-title":"Active surveillance is an excellent management technique for identifying patients with progressive low-risk papillary thyroid microcarcinoma requiring surgical treatment","volume":"70","author":"M Fujishima","year":"2023","journal-title":"Endocr J"},{"issue":"2","key":"pone.0327423.ref027","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/s00268-022-06770-z","article-title":"Thyroid-stimulating hormone, age, and tumor size are risk factors for progression during active surveillance of low-risk papillary thyroid microcarcinoma in adults","volume":"47","author":"Y Ito","year":"2023","journal-title":"World J Surg"},{"issue":"2","key":"pone.0327423.ref028","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1089\/thy.2020.0330","article-title":"Indications and strategy for active surveillance of adult low-risk papillary thyroid microcarcinoma: consensus statements from the Japan Association of Endocrine Surgery Task Force on management for papillary thyroid microcarcinoma","volume":"31","author":"I Sugitani","year":"2021","journal-title":"Thyroid"},{"issue":"1","key":"pone.0327423.ref029","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1001\/jamasurg.2022.5781","article-title":"Comparison of lobectomy vs total thyroidectomy for intermediate-risk papillary thyroid carcinoma with lymph node metastasis","volume":"158","author":"S Xu","year":"2023","journal-title":"JAMA Surg"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T17:29:53Z","timestamp":1752082193000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327423"}},"subtitle":[],"editor":[{"given":"Paolo","family":"Boffano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,7,9]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0327423","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,9]]}}}