Camargo R S, Scafuri A G, de Tolosa E M, Ferreira E A
University of São Paulo, University Hospital, Brazil.
Am J Surg. 1992 Dec;164(6):640-5. doi: 10.1016/s0002-9610(05)80724-x.
A total of 117 differentiated thyroid adenocarcinomas that had been removed by total thyroidectomy were studied. Seventy (60%) were papillary, 36 (30%) were follicular, and 11 (10%) were Hürthle cell adenocarcinomas. The mean length of follow-up was 57.7 months. Adverse prognostic factors according to multivariate analysis were adjacent tissue infiltration (p = 0.0004), histologic type (p = 0.0049), and patient age (p = 0.033). The nuclear DNA content of tumor cells and of morphologically normal adjacent tissue was assessed by image cytometry, and correlations between nuclear DNA content and prognostic factors were examined. Fifty-four (75%) adenocarcinomas were classified as aneuploid, 9 (13%) as diploid, and 9 (12%) as borderline. Thirty-four (60%) specimens of morphologically normal adjacent tissue were classified as aneuploid, 18 (32%) as diploid, and 5 (8%) as borderline. The correlation between tumor ploidy and selected prognostic factors was statistically significant for patient age (p = 0.004) and histologic type (p = 0.033). Despite the fact that ploidy could not be identified as a prognostic factor, we suggest that, because of its correlation with age and histologic type, it might prove prognostic if the number of patients were increased. We also emphasize the importance of evaluating morphologically normal adjacent tissue because of the high rates of aneuploidy in these areas.
对117例因甲状腺全切术切除的分化型甲状腺癌进行了研究。其中70例（60%）为乳头状癌，36例（30%）为滤泡状癌，11例（10%）为许特莱细胞腺癌。平均随访时间为57.7个月。多因素分析显示，不良预后因素包括邻近组织浸润（p = 0.0004）、组织学类型（p = 0.0049）和患者年龄（p = 0.033）。通过图像细胞术评估肿瘤细胞及形态学正常的邻近组织的核DNA含量，并检测核DNA含量与预后因素之间的相关性。54例（75%）腺癌为非整倍体，9例（13%）为二倍体，9例（12%）为临界型。34例（60%）形态学正常的邻近组织标本为非整倍体，18例（32%）为二倍体，5例（8%）为临界型。肿瘤倍体与选定的预后因素之间的相关性在患者年龄（p = 0.004）和组织学类型（p = 0.033）方面具有统计学意义。尽管倍体不能被确定为预后因素，但我们认为，由于其与年龄和组织学类型相关，如果增加患者数量，可能证明其具有预后价值。我们还强调评估形态学正常的邻近组织的重要性，因为这些区域的非整倍体发生率很高。
