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实性型甲状腺乳头状癌的临床病理特征

Clinicopathologic features of solid variant papillary thyroid cancer.

作者信息

Chang Hojin, Kim Seok Mo, Chun Ki Won, Kim Bup Woo, Lee Yong Sang, Chang Hang-Seok, Hong Soon Won, Park Cheong Soo

机构信息

Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

ANZ J Surg. 2014 May;84(5):380-2. doi: 10.1111/ans.12307. Epub 2013 Jul 4.

Abstract

BACKGROUND

Solid variant papillary thyroid cancer (SVPTC) is a rare type of thyroid malignancy whose clinical characteristics remain poorly defined. Therefore, we evaluated the characteristics of 14 patients with SVPTC treated at our institution.

METHODS

Of the 6052 patients with papillary thyroid cancer (PTC) evaluated at our institution between January 2008 and December 2011, 14 (0.23%) had SVPTC and were analysed retrospectively.

RESULTS

Of the 14 patients with SVPTC, two were men and 12 were women, with a mean age of 48.2 years (range: 33-72 years). The mean follow-up period was 24 months (range: 8-36 months). All patients were assessed preoperatively by ultrasound-guided fine needle aspiration cytology (FNAC), with the diagnosis confirmed by permanent pathology and immunohistochemical staining performed by a specialized endocrine pathologist. Only one patient was diagnosed with SVPTC by preoperative FNAC, whereas 11 (78.6%) were diagnosed with PTC or suspected of having PTC. The mean tumour size was 1.02 ± 0.30 cm, with all tumours less than 2.0 cm in diameter. The infiltrative tumour margins were observed in eight patients (57.1%) and the extrathyroidal invasion in seven (50.0%). The central lymph node metastases were found in five patients (35.7%), and the lateral lymph node metastasis in one (7.1%). No patient experienced tumour recurrence or distant metastasis during follow-up.

CONCLUSIONS

Despite the small sample size and the short follow-up period, our results indicate that SVPTC may not be as aggressive a subtype as previously thought.

摘要

背景

实性变异型甲状腺乳头状癌(SVPTC)是一种罕见的甲状腺恶性肿瘤,其临床特征仍未明确。因此,我们评估了在我院接受治疗的14例SVPTC患者的特征。

方法

在2008年1月至2011年12月期间于我院接受评估的6052例甲状腺乳头状癌(PTC)患者中,14例(0.23%)为SVPTC,并进行回顾性分析。

结果

14例SVPTC患者中,男性2例,女性12例,平均年龄48.2岁(范围:33 - 72岁)。平均随访期为24个月(范围:8 - 36个月)。所有患者术前均通过超声引导下细针穿刺细胞学检查(FNAC)进行评估,诊断经永久性病理检查确认,并由专业内分泌病理学家进行免疫组化染色。术前FNAC仅1例诊断为SVPTC,而11例(78.6%)诊断为PTC或疑似PTC。平均肿瘤大小为1.02±0.30 cm,所有肿瘤直径均小于2.0 cm。8例患者(57.1%)观察到浸润性肿瘤边缘,7例(50.0%)出现甲状腺外侵犯。5例患者(35.7%)发现中央淋巴结转移,1例(7.1%)出现侧方淋巴结转移。随访期间无患者出现肿瘤复发或远处转移。

结论

尽管样本量小且随访期短,但我们的结果表明SVPTC可能不像之前认为的那样具有侵袭性。

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