Hirokawa Mitsuyoshi, Ito Yasuhiro, Kuma Seiji, Takamura Yuuki, Miya Akihiro, Kobayashi Kaoru, Miyauchi Akira
Department of Diagnostic Pathology, Kuma Hospital, Kobe, Japan.
Oncol Lett. 2010 Sep;1(5):873-876. doi: 10.3892/ol_00000154. Epub 2010 Sep 1.
The clinical significance of nodal metastasis in well-differentiated follicular carcinoma (WD-FC) of the thyroid remains a controversial issue. This study aimed to clarify clinical and pathological characteristics of WD-FC with nodal metastasis, based on the new WHO classification. We examined 249 WD-FC cases diagnosed between 1983 and 2004 in our hospital. Poorly differentiated follicular carcinoma was not included in this study. Of the 249 WD-FC cases, 9 (3.6%) revealed nodal metastasis. The incidences of nodal metastasis in minimally invasive and widely invasive cases were 2.0 and 9.8%, respectively. In four patients, nodal metastasis was detected in the ipsilateral lymph nodes during the initial surgery. A total of 6 patients presented with nodal metastasis 2-10 years after the initial operation, and 3 patients with bilateral and large nodal metastases were relatively young. No patients succumbed to the carcinoma. Primary lesions of WD-FC with nodal metastasis were microscopically conventional, and there were no findings predicting nodal metastasis. We hypothesized that the incidence of nodal metastasis in WD-FC, based on the new WHO classification, was lower compared with previous reports. Younger individuals may be at a higher risk of large bilateral nodal metastasis. The presence of nodal metastasis did not affect the long-term outcome of follicular carcinoma.
甲状腺高分化滤泡癌（WD-FC）中淋巴结转移的临床意义仍是一个有争议的问题。本研究旨在基于世界卫生组织（WHO）新分类法阐明伴有淋巴结转移的WD-FC的临床和病理特征。我们研究了1983年至2004年间在我院诊断的249例WD-FC病例。本研究未纳入低分化滤泡癌。在这249例WD-FC病例中，9例（3.6%）出现淋巴结转移。微侵袭性和广泛侵袭性病例的淋巴结转移发生率分别为2.0%和9.8%。4例患者在初次手术时发现同侧淋巴结转移。共有6例患者在初次手术后2至10年出现淋巴结转移，3例双侧及大淋巴结转移患者相对年轻。无患者死于该癌症。伴有淋巴结转移的WD-FC原发灶在显微镜下为典型表现，未发现预测淋巴结转移的特征。我们推测，基于WHO新分类法，WD-FC的淋巴结转移发生率低于既往报道。较年轻个体可能发生双侧大淋巴结转移的风险更高。淋巴结转移的存在并不影响滤泡癌的长期预后。
