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低分化甲状腺癌:一项回顾性临床病理研究。

Poorly differentiated thyroid carcinoma: a retrospective clinicopathological study.

作者信息

Cherkaoui Ghofrane Salhi, Guensi Amal, Taleb Sara, Idir Malika Ait, Touil Najwa, Benmoussa Rita, Baroudi Zaineb, Chikhaoui Nabil

机构信息

Nuclear Medicine Department, Ibn Rochd University Hospital, Université Hassan II, Casablanca, Morocco.

Emergency Radiology Department, Ibn Rochd University Hospital, Université Hassan II Casablanca, Morocco.

出版信息

Pan Afr Med J. 2015 Jun 22;21:137. doi: 10.11604/pamj.2015.21.137.6720. eCollection 2015.

Abstract

Poorly differentiated thyroid carcinoma (PDTC) is an independent thyroid cancer histotype. In spite of its scarcity, it represents the main cause of death from non-anaplastic follicular cell-derived thyroid cancer. However, given the newness of this entity, few data are available on its clinical behaviour and no explicit consensus sets its treatment. To report the experience of a tertiary medical centre in morocco with PDTC over a period of 7 years. Retrospective study selecting all patients treated for thyroid carcinoma in Nuclear Medicine Department of a tertiary medical centre in Casablanca over seven years period. Patient's files were reviewed for background data, clinico-pathological characteristics, treatment and outcome. Seven patients were included in the study. Patient's average age was 60 years old (30-81) including six women and one man. All patients underwent a total thyroidectomy completed by cervical lymph node dissection in 57% of cases. Mean primary tumour size was 4cm (1-9cm). Patients were classified pT3 in 70% of cases, pT1 and pT2 in 15% each. Vascular invasion was found in 85% of cases. Pathological subtypes found were "insular carcinoma" in 85% of cases. Radioiodine therapy (RIT) was indicated in all cases. Follow-up period ranged between 10 months and 6 years. It showed a complete remission in 57% of cases, persistent disease in 28% of cases and a progressive disease in 15% of cases with a local recurrence. To date, the survival rate is 85%. PDTC is an aggressive thyroid cancer histotype. Treatment remains surgical followed by RIT if the tumour is radioavid. Multimodality therapy is indicated depending on the case and close monitoring is always indicated given the high risk of relapse.

摘要

低分化甲状腺癌(PDTC)是一种独立的甲状腺癌组织学类型。尽管其发病率较低,但它是非间变性滤泡细胞源性甲状腺癌的主要死亡原因。然而,鉴于该实体较新,关于其临床行为的数据很少,且对于其治疗尚无明确的共识。报告摩洛哥一家三级医疗中心7年来治疗PDTC的经验。回顾性研究选取了卡萨布兰卡一家三级医疗中心核医学科7年间所有接受甲状腺癌治疗的患者。查阅患者病历以获取背景数据、临床病理特征、治疗及转归情况。7例患者纳入研究。患者平均年龄60岁(30 - 81岁),其中6名女性,1名男性。所有患者均接受了全甲状腺切除术,57%的病例同时进行了颈部淋巴结清扫。原发肿瘤平均大小为4cm(1 - 9cm)。70%的病例患者被分类为pT3,15%的病例为pT1和pT2。85%的病例发现有血管侵犯。85%的病例病理亚型为“岛状癌”。所有病例均采用放射性碘治疗(RIT)。随访期为10个月至6年。结果显示57%的病例完全缓解,28%的病例疾病持续存在,15%的病例疾病进展并伴有局部复发。迄今为止,生存率为8%。PDTC是一种侵袭性甲状腺癌组织学类型。治疗仍以手术为主,如果肿瘤具有放射性摄取则术后进行RIT。根据具体情况采用多模式治疗,鉴于复发风险高,始终需要密切监测。

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本文引用的文献

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Outcomes in patients with poorly differentiated thyroid carcinoma.低分化甲状腺癌患者的预后。
J Clin Endocrinol Metab. 2014 Apr;99(4):1245-52. doi: 10.1210/jc.2013-3842. Epub 2014 Feb 10.
3
Insular thyroid carcinoma: a retrospective clinicopathologic study.岛状甲状腺癌:回顾性临床病理研究。
Am J Otolaryngol. 2013 Jul-Aug;34(4):292-5. doi: 10.1016/j.amjoto.2012.12.009. Epub 2013 Jan 26.
4
Poorly differentiated thyroid carcinoma: an incubating entity.低分化甲状腺癌:一种隐匿性疾病。
Front Endocrinol (Lausanne). 2012 Jun 21;3:77. doi: 10.3389/fendo.2012.00077. eCollection 2012.

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