Endocrinology, Department of Clinical and Molecular Bio-Medicine, University of Catania, Garibaldi-Nesima Hospital, Via Palermo 636, 95122 Catania, Italy.
J Endocrinol Invest. 2013 Apr;36(4):249-54. doi: 10.3275/8515. Epub 2012 Jul 9.
The tall cell variant (TCV) is a relatively rare variant of papillary thyroid cancer. Since a controversy exists whether or not the TCV has a worse outcome, the aim of our study was to retrospectively compare the clinicopathological features and outcomes in a group of TCV patients and a larger group of patients with classical papillary thyroid carcinoma (cPTC).
Data from 30 TCV and 293 cPTC patients were analyzed. Among the 293 cPTC, we also selected a "high-risk" cPTC group (no.=103) that was treated with the same protocol used for the TCV patients. All data were managed by Cox analysis.
Compared to all cPTC patients, TCV subjects displayed only a significantly higher rate of extrathyroid extension. At multivariate analysis, TCV was not an independent variable for the prediction of a high risk of persistent/recurrent disease. At the last follow-up observation, there was no difference in the disease status between the TCV and all cPTC patients. Moreover, "high-risk" cPTC patients had a significant increase in persistent/recurrent disease.
In our study, although the TCV histotype is associated with a higher prevalence of extrathyroid extension, it is characterized by an outcome that is not significantly different from that of all cPTC patients and is more favorable than that of "high-risk" cPTC patients. Only those TCV patients classified as "high risk" based on specific pathological and clinical features, according to current guidelines, should be treated aggressively, such as with a total thyroidectomy, neck lymph node dissection or ablative radioiodine treatment.
高细胞型（TCV）是甲状腺乳头状癌的一种相对罕见的变体。由于 TCV 是否具有更差的结局存在争议，因此我们的研究目的是回顾性比较一组 TCV 患者和一组更大的经典型甲状腺乳头状癌（cPTC）患者的临床病理特征和结局。
分析了 30 例 TCV 和 293 例 cPTC 患者的数据。在 293 例 cPTC 中，我们还选择了一组“高危”cPTC 患者（n=103），他们接受了与 TCV 患者相同的治疗方案。所有数据均通过 Cox 分析进行管理。
与所有 cPTC 患者相比，TCV 患者仅表现出更高的甲状腺外扩展率。多变量分析显示，TCV 不是预测持续性/复发性疾病高风险的独立变量。在最后一次随访观察时，TCV 和所有 cPTC 患者的疾病状况没有差异。此外，“高危”cPTC 患者持续性/复发性疾病的发生率显著增加。
在我们的研究中，虽然 TCV 组织学类型与更高的甲状腺外扩展发生率相关，但它的结局与所有 cPTC 患者没有显著差异，并且比“高危”cPTC 患者的结局更有利。只有那些根据当前指南，根据特定的病理和临床特征被归类为“高危”的 TCV 患者才需要积极治疗，例如全甲状腺切除术、颈部淋巴结清扫或消融性碘治疗。
