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肿瘤包膜侵犯在高分化甲状腺癌中的意义。

Significance of tumor capsular invasion in well-differentiated thyroid carcinomas.

作者信息

Furlan Julio C, Bedard Yvan C, Rosen Irving B

机构信息

Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

出版信息

Am Surg. 2007 May;73(5):484-91.

Abstract

This study examines the influence of tumor capsular invasion on the biological behavior of papillary (PTC) and follicular thyroid carcinoma (FTC) and the prognosis of surgically treated patients. This retrospective cohort study included 350 cases of PTC or FTC from a university teaching hospital. Patient charts were randomly selected and reviewed. The study population was divided into PTC and FTC groups. Each group was subdivided into CI+ (with tumor capsular invasion) and CI- subgroups (without tumor capsule or without capsular invasion). The long-term prognosis was assessed using the American Joint Committee on Cancer pTNM staging and the prognostic index was elaborated by the European Organization for Research and Treatment of Cancer. There were 284 women and 66 men (ages 19-89 years, mean of 44) with an incidence of 53.1 per cent for CI+ tumors. There were no significant differences between the PTC subgroups regarding the short-term clinical outcome and the long-term prognosis. Although patients with CI+ FTC showed lower incidence of lymph node metastasis than patients with CI- FTC, the FTC subgroups were comparable regarding the short-term clinical outcome and the long-term prognosis. Our results suggest that presence of tumor capsular invasion does not adversely influence biological behavior or survival of PTC or FTC. Moreover, the presence of tumor capsular invasion appears to not have significance for the long-term prognosis of patients with PTC or FTC.

摘要

本研究探讨肿瘤包膜侵犯对乳头状甲状腺癌(PTC)和滤泡状甲状腺癌(FTC)生物学行为及手术治疗患者预后的影响。这项回顾性队列研究纳入了某大学教学医院的350例PTC或FTC病例。随机选取并查阅患者病历。研究人群分为PTC组和FTC组。每组再细分为CI+(有肿瘤包膜侵犯)和CI-亚组(无肿瘤包膜或无包膜侵犯)。采用美国癌症联合委员会pTNM分期评估长期预后,并由欧洲癌症研究与治疗组织制定预后指数。共有284名女性和66名男性(年龄19 - 89岁,平均44岁),CI+肿瘤的发生率为53.1%。PTC亚组在短期临床结局和长期预后方面无显著差异。虽然CI+ FTC患者的淋巴结转移发生率低于CI- FTC患者,但FTC亚组在短期临床结局和长期预后方面具有可比性。我们的结果表明,肿瘤包膜侵犯的存在不会对PTC或FTC的生物学行为或生存产生不利影响。此外,肿瘤包膜侵犯的存在似乎对PTC或FTC患者的长期预后没有意义。

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