Zhu Zhaowen, Gandhi Manoj, Nikiforova Marina N, Fischer Andrew H, Nikiforov Yuri E
Departments of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, 231 Albert Sabin Way, PO Box 670529, Cincinnati, OH 45267-0529, USA.
Am J Clin Pathol. 2003 Jul;120(1):71-7. doi: 10.1309/ND8D-9LAJ-TRCT-G6QD.
The follicular variant (FV) of papillary thyroid carcinoma is characterized by a follicular growth pattern and cytologic features of papillary carcinoma. ret/PTC rearrangements are common in classic papillary thyroid carcinoma (PTC) and PAX8-PPAR gamma and ras mutations in follicular thyroid carcinoma. Their prevalence in FV has not been established. We studied these genetic alterations and clinical-pathologic features in 30 FV cases and compared those with 46 non-FV papillary carcinomas. FV cases revealed 1 ret/PTC rearrangement (3%) and 13 ras mutations (43%). Non-FV cases harbored 13 ret/PTC (28%) (P = .006) and no ras mutations (P = .0002). No PAX8-PPAR gamma was found in either group. FV cases demonstrated a significantly higher prevalence of tumor encapsulation, angiovascular invasion, and poorly differentiated areas and a lower rate of lymph node metastases. These data indicate that the FV of papillary carcinoma has a distinct set of molecular alterations and is characterized by a high frequency of ras point mutations.
甲状腺乳头状癌的滤泡状变异型（FV）以滤泡状生长模式和乳头状癌的细胞学特征为特点。ret/PTC重排在经典甲状腺乳头状癌（PTC）中常见，而PAX8-PPARγ和ras突变在滤泡状甲状腺癌中常见。它们在FV中的发生率尚未确定。我们研究了30例FV病例中的这些基因改变和临床病理特征，并将其与46例非FV乳头状癌进行比较。FV病例显示1例ret/PTC重排（3%）和13例ras突变（43%）。非FV病例有13例ret/PTC（28%）（P = .006）且无ras突变（P = .0002）。两组均未发现PAX8-PPARγ。FV病例显示肿瘤包膜、血管侵犯和低分化区域的发生率显著更高，而淋巴结转移率更低。这些数据表明，乳头状癌的FV具有独特的分子改变组合，且以ras点突变的高频率为特征。
