Section of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.
Thyroid. 2013 Oct;23(10):1263-8. doi: 10.1089/thy.2012.0453. Epub 2013 Sep 11.
Follicular variant of papillary thyroid carcinoma (FV-PTC) has been increasingly diagnosed in recent years. However, little is known about its clinical behavior. The purpose of this study was to determine the disease characteristics of FV-PTC, and to compare it with classical papillary thyroid carcinoma (C-PTC) and follicular thyroid carcinoma (FTC).
All cases of C-PTC, FV-PTC, and FTC larger than 1 cm in the Surveillance, Epidemiology and End Results (SEER) Cancer Database from 1988 to 2007 were identified. Tumor behavior and patient survival were compared among these three groups. Different risk factors for disease-specific mortality in each group were evaluated by multivariate analysis.
More than 36,000 surgical cases were identified, including 21,796 C-PTCs, 10,740 FV-PTCs, and 3958 FTCs. Extrathyroidal extension and lymph-node metastases were more common in FV-PTC than in FTC, but significantly less common than in C-PTC (p<0.0001). Distant metastasis rates were present in 2% of patients with FV-PTC, in 1% with C-PTC, and in 4% with FTC (p<0.0001). The 10-year disease-specific survival for patients with FV-PTC was 98%, similar to C-PTC (97%) but better than FTC (94%, p<0.0001). Being over the age of 45 years remained a strong risk factor for disease-specific mortality in both FV-PTC and C-PTC, while the presence of extrathyroidal extension and distant metastases were stronger predictors of disease-specific mortality in FV-PTC than in C-PTC.
FV-PTC is a common variant of PTC. Its clinical behavior is unique and represents an intermediate entity with clinical features that are between C-PTC and FTC. Interestingly, despite the variations in clinical behavior, the long-term outcome of these patients remains excellent and similar to C-PTC.
滤泡型甲状腺癌（FV-PTC）在近年来的诊断率逐渐升高。然而，人们对其临床行为知之甚少。本研究旨在确定 FV-PTC 的疾病特征，并将其与经典型甲状腺乳头状癌（C-PTC）和滤泡状甲状腺癌（FTC）进行比较。
从 1988 年至 2007 年的监测、流行病学和最终结果（SEER）癌症数据库中确定了 C-PTC、FV-PTC 和大于 1cm 的 FTC 的所有病例。比较三组之间的肿瘤行为和患者生存情况。通过多变量分析评估每组疾病特异性死亡率的不同危险因素。
共确定了 36000 多例手术病例，包括 21796 例 C-PTC、10740 例 FV-PTC 和 3958 例 FTC。FV-PTC 的甲状腺外侵犯和淋巴结转移比 FTC 更常见，但明显少于 C-PTC（p<0.0001）。FV-PTC 患者的远处转移率为 2%，C-PTC 为 1%，FTC 为 4%（p<0.0001）。FV-PTC 患者的 10 年疾病特异性生存率为 98%，与 C-PTC（97%）相似，但优于 FTC（94%，p<0.0001）。年龄超过 45 岁仍然是 FV-PTC 和 C-PTC 疾病特异性死亡的强烈危险因素，而甲状腺外侵犯和远处转移的存在是 FV-PTC 疾病特异性死亡的预测因素，比 C-PTC 更强。
FV-PTC 是 PTC 的常见变体。其临床行为是独特的，代表了一种介于 C-PTC 和 FTC 之间的中间实体。有趣的是，尽管临床行为存在差异，但这些患者的长期预后仍然很好，与 C-PTC 相似。
