Nikiforov Y E, Erickson L A, Nikiforova M N, Caudill C M, Lloyd R V
Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, Ohio 45267-0529, USA.
Am J Surg Pathol. 2001 Dec;25(12):1478-84. doi: 10.1097/00000478-200112000-00002.
Solid variant is a rare and poorly characterized variant of papillary thyroid carcinoma. In this study we analyzed 20 primary cases of the solid variant of papillary carcinoma found in a series of 756 papillary carcinomas operated at the Mayo Clinic between 1962 and 1989. The criteria for classification included predominantly (>70%) solid growth pattern of primary tumor, retention of cytologic features typical of papillary carcinoma, and absence of tumor necrosis. For each case of the solid variant, a control case of classical papillary carcinoma matched by age, sex, tumor size, and length of follow-up was selected. The follow-up ranged from 6 to 32 years. Two patients with the solid variant of papillary carcinoma (10%) died from disease 7 and 10 years after initial surgery, while another two patients (10%) are alive with lung metastases. In contrast, the control group had no cases with distant metastases or death from disease. Molecular analyses showed a similar prevalence of RET /PTC rearrangements in both groups. In conclusion, the solid variant of papillary carcinoma is associated with a slightly higher frequency of distant metastases and less favorable prognosis than classical papillary carcinoma. However, it should be distinguished from poorly differentiated thyroid carcinoma, which has a reported lower survival rate compared with the solid variant of papillary carcinoma.
实性变体是一种罕见且特征不明的甲状腺乳头状癌变体。在本研究中，我们分析了1962年至1989年间在梅奥诊所接受手术的756例乳头状癌系列中发现的20例原发性乳头状癌实性变体病例。分类标准包括原发性肿瘤主要为（>70%）实性生长模式、保留乳头状癌典型的细胞学特征以及无肿瘤坏死。对于每例实性变体病例，选择了年龄、性别、肿瘤大小和随访时间相匹配的经典乳头状癌对照病例。随访时间为6至32年。两名乳头状癌实性变体患者（10%）在初次手术后7年和10年死于该疾病，而另外两名患者（10%）存活但有肺转移。相比之下，对照组没有远处转移或死于该疾病的病例。分子分析显示两组中RET/PTC重排的发生率相似。总之，乳头状癌实性变体与远处转移频率略高以及预后比经典乳头状癌差有关。然而，它应与低分化甲状腺癌相区分，据报道低分化甲状腺癌的生存率低于乳头状癌实性变体。
