Kakudo Kennichi, Bai Yanhua, Katayama Shoichi, Hirokawa Mitsuyoshi, Ito Yasuhiro, Miyauchi Akira, Kuma Kanji
Department of Human Pathology, Wakayama Medical University, Wakayama, Japan.
Pathol Int. 2009 Jun;59(6):359-67. doi: 10.1111/j.1440-1827.2009.02378.x.
Prognostic analyses of thyroid carcinomas of follicular cell origin were carried out on patients treated at Kuma Hospital, Kobe, Japan. A new histopathological classification based on the prognostic evidence is proposed in this study, and it is applicable to the patients treated curatively. Major histological types of papillary carcinoma, follicular carcinoma and poorly differentiated carcinoma were combined into one single entity of follicular cell adenocarcinoma because (i) they have the same cell origin (follicular cell); (ii) clear-cut separation of papillary and follicular carcinoma is not always possible, and 10 year cause-specific survival was essentially similar when the patients were treated curatively; and (iii) poorly differentiated carcinoma usually has a background of either papillary or follicular carcinoma. This adenocarcinoma together with undifferentiated carcinoma was stratified into four prognostic groups using pure morphological criteria of the degree of cellular differentiation and histological grade. They are termed well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated carcinoma and undifferentiated carcinoma of the thyroid. The 10 year disease-free survival rates were 86.3-93.1%, 65.4-78.7%, and 43.0-53.8%, and 0%, respectively. The 10 year cause-specific survival rates were 97.2-100%, 91.5-97.4%, and 71.2-80.0%, and 0%, respectively.
对在日本神户熊本医院接受治疗的滤泡细胞源性甲状腺癌患者进行了预后分析。本研究基于预后证据提出了一种新的组织病理学分类方法，该方法适用于接受根治性治疗的患者。乳头状癌、滤泡状癌和低分化癌的主要组织学类型被合并为滤泡细胞腺癌这一单一实体，原因如下：（i）它们具有相同的细胞起源（滤泡细胞）；（ii）乳头状癌和滤泡状癌并非总能明确区分，且接受根治性治疗的患者10年病因特异性生存率基本相似；（iii）低分化癌通常具有乳头状癌或滤泡状癌的背景。利用细胞分化程度和组织学分级的纯形态学标准，将这种腺癌与未分化癌分为四个预后组。它们分别被称为甲状腺高分化腺癌、中分化腺癌、低分化癌和未分化癌。10年无病生存率分别为86.3% - 93.1%、65.4% - 78.7%、43.0% - 53.8%和0%。10年病因特异性生存率分别为97.2% - 100%、91.5% - 97.4%、71.2% - 80.0%和0%。
