Department of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Laryngoscope. 2010 Apr;120(4):712-6. doi: 10.1002/lary.20828.
OBJECTIVES/HYPOTHESIS: To determine the prevalence and extent of disease characteristics of the follicular variant of papillary thyroid carcinoma (FV-PTC) and the survival impact of this histopathological diagnosis compared to classical papillary thyroid carcinoma (C-PTC).
Cross-sectional population analysis of a national cancer database.
Cases of C-PTC and FV-PTC were extracted from the Surveillance, Epidemiology and End Results database for 1988 to 2006 and staged. Surgical extent and radioactive iodine (RAI) use were determined. Demographic and staging parameters were statistically compared according to tumor histology. Survival differences according to histology were determined with a Cox proportional hazards model, adjusting for age, sex, T stage, N stage, surgical therapy, and RAI.
A total of 46,699 patients were identified (68.4% C-PTC and 31.6% FV-PTC). Age at presentation and sex distribution were similar between FV-PTC (47.9 years; 79.3% female) and C-PTC patients (46.2 years; 77.3% female). Although nodal disease prevalence was significantly lower in FV-PTC compared to C-PTC (14.8% vs. 27.8%, respectively; P < .001), T stage was not significantly different (P = .450). Mean overall survivals for patients with FV-PTC (204.5 months) and C-PTC (205.3 months) were not significantly different (P = .373). Cox regression analysis revealed that advanced age (P < .001), male sex (P < .001), advanced T stage (P < .001), and positive nodal disease (P < .001) were associated with reduced overall survival, whereas histopathological subtype was not (P = .360).
Disease presentation (with exception of nodal metastasis) and survival in patients with FV-PTC are statistically similar to that of C-PTC, and accordingly these patients carry very similar prognoses.
目的/假设：确定滤泡型甲状腺乳头状癌（FV-PTC）的疾病特征的患病率和程度，以及与经典型甲状腺乳头状癌（C-PTC）相比，这种组织病理学诊断对生存的影响。
对国家癌症数据库进行的横断面人群分析。
从 1988 年至 2006 年的监测、流行病学和最终结果数据库中提取 C-PTC 和 FV-PTC 病例，并对其进行分期。确定手术范围和放射性碘（RAI）的使用。根据肿瘤组织学，对人口统计学和分期参数进行统计学比较。使用 Cox 比例风险模型确定组织学差异的生存差异，调整年龄、性别、T 分期、N 分期、手术治疗和 RAI。
共确定了 46699 例患者（68.4%为 C-PTC，31.6%为 FV-PTC）。FV-PTC（47.9 岁；79.3%为女性）和 C-PTC 患者的发病年龄和性别分布相似（46.2 岁；77.3%为女性）。尽管 FV-PTC 患者的淋巴结疾病患病率明显低于 C-PTC（分别为 14.8%和 27.8%；P<.001），但 T 分期无显著差异（P=0.450）。FV-PTC（204.5 个月）和 C-PTC（205.3 个月）患者的总生存率无显著差异（P=0.373）。Cox 回归分析显示，年龄较大（P<.001）、男性（P<.001）、较高的 T 分期（P<.001）和阳性淋巴结疾病（P<.001）与总生存时间缩短相关，而组织病理学亚型无关（P=0.360）。
FV-PTC 患者的疾病表现（除淋巴结转移外）和生存与 C-PTC 统计学上相似，因此这些患者具有非常相似的预后。
