伴有结节性甲状腺肿的甲状腺髓样癌预后极好。

Medullary thyroid carcinoma with nodular goiter carries an excellent prognosis.

机构信息

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

J Surg Oncol. 2012 Aug 1;106(2):169-73. doi: 10.1002/jso.23070. Epub 2012 Feb 21.

DOI:10.1002/jso.23070

PMID:22354558

Abstract

BACKGROUND

In our institution, patients with medullary thyroid carcinoma (MTC) concurrent with nodular goiter (NG) have a nearly 100% survival rate, but the reasons and characteristics are unclear.

METHODS

Eighty patients with MTC who underwent surgery in our center between 1971 and 2011 were reviewed.

RESULTS

A total of 21 MTC/NG and 59 MTC only patients were identified. The stage of the two groups had no significant difference (P = 0.13). The MTC/NG group had lower preoperative serum calcitonin (CT) levels (914.7 ng/L vs. 1162.6 ng/L, P = 0.003), lower postoperative serum CT levels (371.4 ng/L vs. 582.5 ng/L, P < 0.001), lower carcinoembryonic antigen levels (18.3 ng/ml vs. 130.5 ng/ml, P < 0.001), a lower propensity toward lymph node metastasis (40.0% vs. 66.7%, P = 0.07), and a lower proportion of multifocality (19.1% vs. 42.4%, P = 0.06), capsular invasion (9.5% vs. 25.4%, P = 0.21), and vascular invasion (4.8% vs. 10.1%, P = 0.67). The mean tumor diameter of the two groups was similar (20.3 mm vs. 22.1 mm, P = 0.6). Overall 15-year survival in MTC/NG versus MTC only groups was 100% versus 57.0% (P = 0.03).

CONCLUSIONS

MTC with NG is an indolent disease and has an excellent prognosis. The only independent predictor of survival was the TNM stage of disease.

摘要

背景

在我们的机构中，同时患有甲状腺髓样癌（MTC）和结节性甲状腺肿（NG）的患者几乎达到 100%的存活率，但原因和特征尚不清楚。

方法

回顾了 1971 年至 2011 年间在我们中心接受手术的 80 例 MTC 患者的临床资料。

结果

共发现 21 例 MTC/NG 和 59 例 MTC 仅患者。两组的分期无显著差异（P=0.13）。MTC/NG 组术前降钙素（CT）水平较低（914.7ng/L 比 1162.6ng/L，P=0.003），术后 CT 水平较低（371.4ng/L 比 582.5ng/L，P<0.001），癌胚抗原（CEA）水平较低（18.3ng/ml 比 130.5ng/ml，P<0.001），淋巴结转移倾向较低（40.0%比 66.7%，P=0.07），多灶性比例较低（19.1%比 42.4%，P=0.06），包膜侵犯率较低（9.5%比 25.4%，P=0.21），血管侵犯率较低（4.8%比 10.1%，P=0.67）。两组肿瘤平均直径相似（20.3mm 比 22.1mm，P=0.6）。MTC/NG 组与 MTC 仅组 15 年总生存率分别为 100%和 57.0%（P=0.03）。