Department of Surgical Oncology, Institute of Oncology, Zaloska, Ljubljana, Slovenia.
J Surg Oncol. 2012 Mar 15;105(4):351-6. doi: 10.1002/jso.22030. Epub 2011 Jul 12.
A distinction between a benign follicular neoplasm (FN) and a malignant FN based entirely on cytologic examination of fine-needle aspiration biopsy is not possible. The aim of this retrospective study was to find predictive factors of carcinoma in patients with FN.
A chart review of 388 patients (314 females, 74 males; mean age 50 years, range 9-81 years) with FN, who were surgically treated between 1988 and 2009, was performed. Predictive factors for malignancy were identified by the chi-squared test and multivariate logistic regression.
The histopathological diagnoses were carcinoma, adenoma, and benign goiter in 127 (33%), 126 (32%), and 135 (35%) patients, respectively. The independent predictors of malignancy as shown by multivariate logistic regression were age of patients (OR 1.88, P = 0.008), solitary tumor (OR 1.72, P = 0.037), and Tg concentration (OR 2.36, P = 0.001). Carcinoma was more common in patients younger than 45 years, with solitary tumor and with preoperative serum Tg concentration more than 400 ng/ml.
The independent predictors of malignancy in FN were age of patients, solitary tumor, and preoperative Tg concentration. The determination of Tg concentration may be useful in the patients with FN in order to decrease the number of completion thyroidectomies.
完全基于细针穿刺抽吸活检的细胞学检查，滤泡性肿瘤良、恶性之间的鉴别是不可能的。本回顾性研究的目的是寻找滤泡性肿瘤患者发生癌的预测因素。
对 1988 年至 2009 年间手术治疗的 388 例滤泡性肿瘤患者（314 例女性，74 例男性；平均年龄 50 岁，范围 9-81 岁）进行了图表回顾。通过卡方检验和多变量逻辑回归确定恶性肿瘤的预测因素。
组织病理学诊断为癌、腺瘤和良性甲状腺肿分别为 127 例（33%）、126 例（32%）和 135 例（35%）。多变量逻辑回归显示，患者年龄（OR 1.88，P=0.008）、单发肿瘤（OR 1.72，P=0.037）和 Tg 浓度（OR 2.36，P=0.001）是恶性肿瘤的独立预测因素。癌更常见于 45 岁以下、单发肿瘤和术前血清 Tg 浓度大于 400ng/ml 的患者。
滤泡性肿瘤恶性的独立预测因素为患者年龄、单发肿瘤和术前 Tg 浓度。测定 Tg 浓度可能有助于减少滤泡性肿瘤患者行甲状腺全切除术的数量。
