Department of Surgical Oncology, Institute of Oncology, 1000 Ljubljana, Slovenia.
Thyroid. 2013 Jun;23(6):709-13. doi: 10.1089/thy.2012.0252. Epub 2013 May 28.
Despite surgical treatment, chemotherapy, and/or radiotherapy, the vast majority of patients with anaplastic thyroid carcinoma (ATC) have a dismal prognosis. Better knowledge of the frequency of metastases to different sites might help us to perform the appropriate diagnostic tests before treatment and during the course of the disease. The aim of this study was to determine the frequency of metastases from ATC in different sites as found at autopsy.
Altogether, 205 patients were treated for ATC at our institute during the years 1972-2008. Autopsy was performed in 45 cases (30 females, 15 males; median age 66 years). The relative frequencies of metastases in different sites were analyzed using descriptive statistics.
Altogether, 41 cases (91%) had metastases at autopsy. The most common sites of metastases were the lungs (78%), intrathoracic lymph nodes (58%), neck lymph nodes (51%), pleura (29%), adrenal glands (24%), liver (20%), brain (18%), heart (18%), and retroperitoneal lymph nodes (18%). Less common sites of distant metastases were the pericardium (13%), bones (13%), kidneys (13%), mesentery or peritoneum (13%), skin (9%), pancreas (4%), stomach (4%), diaphragm (4%), pituitary gland (2%), ovary (2%), jejunum (2%), axillary lymph nodes (2%), and gingival mucosa (2%). Both distant and regional metastases were present in 23 cases, while only distant metastases were present in 18 cases. An extensive local infiltration of the primary tumor was found in 76% of the cases. The total number of the involved organs and lymph node basins were 123 and 58, respectively. The mean number of metastatic sites was 4.02±2.75. Lung metastases were present in 34 of 38 (89%) of our patients who had distant metastases found at autopsy. Of these 34 patients, 27 were known to have lung metastases when they were alive.
Two or more metastatic sites were found at autopsy in 84% of cases. The most common metastatic sites are lungs, followed by the intrathoracic and neck lymph nodes.
尽管进行了手术治疗、化疗和/或放疗，绝大多数间变性甲状腺癌（ATC）患者的预后仍然很差。更好地了解转移到不同部位的频率可能有助于我们在治疗前和疾病过程中进行适当的诊断测试。本研究的目的是确定尸检中发现的 ATC 在不同部位转移的频率。
1972 年至 2008 年期间，我们研究所共治疗了 205 例 ATC 患者。45 例患者进行了尸检（30 例女性，15 例男性；中位年龄 66 岁）。使用描述性统计分析不同部位转移的相对频率。
总共 41 例（91%）尸检发现转移。最常见的转移部位是肺部（78%）、胸内淋巴结（58%）、颈部淋巴结（51%）、胸膜（29%）、肾上腺（24%）、肝脏（20%）、脑（18%）、心脏（18%）和腹膜后淋巴结（18%）。远处转移较少见的部位包括心包（13%）、骨骼（13%）、肾脏（13%）、肠系膜或腹膜（13%）、皮肤（9%）、胰腺（4%）、胃（4%）、膈肌（4%）、垂体（2%）、卵巢（2%）、空肠（2%）、腋窝淋巴结（2%）和牙龈黏膜（2%）。23 例同时存在远处和局部转移，而仅存在远处转移的有 18 例。76%的病例发现原发肿瘤广泛局部浸润。受累器官和淋巴结总数分别为 123 和 58。平均转移部位数为 4.02±2.75。尸检发现远处转移的 38 例患者中，34 例存在肺部转移。这 34 例患者中，27 例生前已知有肺部转移。
84%的病例尸检发现有两个或两个以上转移部位。最常见的转移部位是肺部，其次是胸内和颈部淋巴结。
Zotero 插件