Besic N, Hocevar M, Zgajnar J, Petric R, Pilko G
Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia.
Thyroid. 2006 Jan;16(1):67-72. doi: 10.1089/thy.2006.16.67.
Hürthle cell papillary thyroid carcinoma (HCPTC) has been studied separately from other types of thyroid carcinoma in relatively few studies. The aim of our study was to determine the factors associated with the survival of patients with HCPTC in Slovenia, an iodine-deficient region. A total of 1552 patients with thyroid carcinoma were seen at our institute during the period of 1976-2003; of them, 42 patients (33 females, 9 males; age 10-85 years, median 56.5 years) had histopathologically verified HCPTC. The data on the patients' gender, age, disease history, extent of disease, morphologic characteristics, therapy, locoregional control, disease-free interval, and survival were collected. The statistical correlation between possible prognostic factors and the disease-free interval and survival was analyzed by chi2 test and log rank analysis. The tumor diameter ranged from 1 to 9 cm (median, 3 cm). Extrathyroid tumor growth was found in 19 patients, lymph node metastases in 13 patients, and distant metastases in 2 patients. Primary treatment consisted of total or near-total thyroidectomy (39 patients), lobectomy (2 patients), radioiodine ablation of the thyroid remnant (37 patients), external irradiation (14 patients), and chemotherapy (3 patients). Locoregional recurrence was diagnosed in four patients, and dissemination in 1 patient during the follow-up period of 0.75-20 years (median, 5.5 years). Three patients died of thyroid carcinoma during the follow-up period. The 5-year and 10-year survivals were 94% and 87%, respectively. The 5-year and 10-year disease-free intervals were 93% and 81%, respectively. The factors correlated with the survival were: age, extrathyroid tumor growth, primary tumor stage, and regional and distant metastases. Although extrathyroidal tumor growth was found in 45% of the patients with HCPTC, our patients had a favorable prognosis. Long-term survival and locoregional control of disease are likely after the radical tumor resection, radioiodine ablation of the thyroid remnant, and external irradiation.
在相对较少的研究中，嗜酸性细胞乳头状甲状腺癌（HCPTC）是与其他类型的甲状腺癌分开进行研究的。我们研究的目的是确定在碘缺乏地区斯洛文尼亚，与HCPTC患者生存相关的因素。1976年至2003年期间，我院共诊治了1552例甲状腺癌患者；其中，42例（女性33例，男性9例；年龄10 - 85岁，中位年龄56.5岁）经组织病理学证实为HCPTC。收集了患者的性别、年龄、病史、疾病范围、形态学特征、治疗、局部区域控制、无病间期和生存数据。通过卡方检验和对数秩分析，分析了可能的预后因素与无病间期和生存之间的统计学相关性。肿瘤直径范围为1至9厘米（中位值为3厘米）。19例患者发现甲状腺外肿瘤生长，13例患者有淋巴结转移，2例患者有远处转移。主要治疗包括全甲状腺切除或近全甲状腺切除（39例）、甲状腺叶切除（2例）、甲状腺残余组织放射性碘消融（37例）、外照射（14例）和化疗（3例）。在0.75至20年（中位值为5.5年）的随访期内，4例患者诊断为局部区域复发，1例患者出现播散。随访期间3例患者死于甲状腺癌。5年和10年生存率分别为94%和87%。5年和10年无病间期分别为93%和81%。与生存相关的因素有：年龄、甲状腺外肿瘤生长、原发肿瘤分期以及区域和远处转移。尽管45%的HCPTC患者发现有甲状腺外肿瘤生长，但我们的患者预后良好。在进行根治性肿瘤切除、甲状腺残余组织放射性碘消融和外照射后，疾病有可能实现长期生存和局部区域控制。
