Oh Woo Jin, Lee Young Sub, Cho Uiju, Bae Ja Seong, Lee Sohee, Kim Min Hee, Lim Dong Jun, Park Gyeong Sin, Lee Youn Soo, Jung Chan Kwon
Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea.
Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
Korean J Pathol. 2014 Jun;48(3):201-8. doi: 10.4132/KoreanJPathol.2014.48.3.201. Epub 2014 Jun 26.
The tall cell variant of papillary thyroid carcinoma (TCVPTC) is more aggressive than classic papillary thyroid carcinoma (PTC), but the percentage of tall cells needed to diagnose TCVPTC remains controversial. In addition, little is known about the clinicopathologic features of classic PTC with tall cell features (TCF).
We retrospectively selected and reviewed the clinicopathologic features and presence of the BRAF mutation in 203 cases of classic PTC, 149 cases of classic PTC with TCF, and 95 cases of TCVPTCs, which were defined as PTCs having <10%, 10-50%, and ≥50% tall cells, respectively.
TCVPTCs and classic PTCs with TCF did not vary significantly in clinicopathologic characteristics such as pathologic (p) T stage, extrathyroidal extension, pN stage, lateral lymph node metastasis, or BRAF mutations; however, these features differed significantly in TCVPTCs and classic PTCs with TCF in comparison to classic PTCs. Similar results were obtained in a subanalysis of patients with microcarcinomas (≤1.0 cm in size).
Classic PTCs with TCF showed a similar BRAF mutation rate and clinicopathologic features to TCVPTCs, but more aggressive characteristics than classic PTCs.
甲状腺乳头状癌高细胞变体(TCVPTC)比经典甲状腺乳头状癌(PTC)侵袭性更强,但诊断TCVPTC所需的高细胞百分比仍存在争议。此外,对于具有高细胞特征(TCF)的经典PTC的临床病理特征知之甚少。
我们回顾性选择并分析了203例经典PTC、149例具有TCF的经典PTC和95例TCVPTC的临床病理特征及BRAF突变情况,其中TCVPTC分别定义为高细胞比例<10%、10 - 50%和≥50%的PTC。
TCVPTC和具有TCF的经典PTC在病理(p)T分期、甲状腺外侵犯、pN分期、侧方淋巴结转移或BRAF突变等临床病理特征方面无显著差异;然而,与经典PTC相比,TCVPTC和具有TCF的经典PTC在这些特征上存在显著差异。在对微癌(≤1.0 cm)患者的亚分析中也得到了类似结果。
具有TCF的经典PTC显示出与TCVPTC相似的BRAF突变率和临床病理特征,但比经典PTC具有更强的侵袭性特征。