Ito Yasuhiro, Kakudo Kennichi, Hirokawa Mitsuyoshi, Fukushima Mitsuhiro, Yabuta Tomonori, Tomoda Chisato, Inoue Hiroyuki, Kihara Minoru, Higashiyama Takuya, Uruno Takashi, Takamura Yuuki, Miya Akihiro, Kobayashi Kaoru, Matsuzuka Fumio, Miyauchi Akira
Department of Surgery, Kuma Hospital, Kobe City, Japan.
Surgery. 2009 Jan;145(1):100-5. doi: 10.1016/j.surg.2008.08.004. Epub 2008 Sep 21.
Although the responsible genes have not yet been identified, it is known that the risk of nonmedullary thyroid carcinoma is elevated in individuals with 1st-degree relatives with nonmedullary thyroid carcinoma. However, it remains controversial whether the biological character of familial nonmedullary carcinoma (FNMTC) differs from that of sporadic carcinoma. In this study, we investigated the prevalence of familial papillary carcinoma and its biological behavior.
Between 1987 and 2004, 6,015 patients underwent initial surgical treatment for papillary carcinoma at Kuma Hospital and 273 (4.5%) were classified as having familial carcinoma. We compared the biological characteristics including prognosis between familial and sporadic papillary carcinomas.
Disease-free survival and cause-specific survival rates of familial carcinoma did not differ from those of sporadic carcinoma. Familial papillary carcinoma showed multicentricity and recurrence to the thyroid more frequently than sporadic carcinoma. There were no differences in other clinicopathological parameters between the 2 groups.
Prognosis of patients with familial papillary carcinoma did not differ from that of those with sporadic papillary carcinoma. Although routine total thyroidectomy is recommended for familial papillary carcinoma, its therapeutic strategy can otherwise be the same as that for sporadic papillary carcinoma.
尽管相关致病基因尚未明确,但已知有非髓样甲状腺癌一级亲属的个体患非髓样甲状腺癌的风险会升高。然而,家族性非髓样癌(FNMTC)的生物学特性是否与散发性癌不同仍存在争议。在本研究中,我们调查了家族性乳头状癌的患病率及其生物学行为。
1987年至2004年间,熊本医院对6015例乳头状癌患者进行了初次手术治疗,其中273例(4.5%)被归类为家族性癌。我们比较了家族性和散发性乳头状癌的生物学特征,包括预后情况。
家族性癌的无病生存率和病因特异性生存率与散发性癌并无差异。家族性乳头状癌比散发性癌更常表现为多中心性且更容易复发至甲状腺。两组之间的其他临床病理参数并无差异。
家族性乳头状癌患者的预后与散发性乳头状癌患者并无差异。尽管对于家族性乳头状癌建议常规行全甲状腺切除术,但其治疗策略在其他方面可与散发性乳头状癌相同。