Liu Lei, Li Dapeng, Wang Hailing, Yang Xiaoyong, Yu Yang, Gao Ming
Department of Otorhinolaryngology, Tianjin Third Central Hospital Tianjin, China.
Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin, China ; Key Laboratory of Cancer Prevention and Therapy Tianjin, China.
Int J Clin Exp Pathol. 2015 Sep 1;8(9):11212-7. eCollection 2015.
Insular thyroid carcinoma (ITC) is a rare type of thyroid malignancy whose aggressiveness and propensity to local recurrence differentiate it from other thyroid malignancies. However, data pertaining to its clinical characteristics is still lacking. In this study, we retrospectively analyzed 10 ITC patients treated and followed in Tianjin Medical University Cancer Institute and Hospital during Apr 2007 to Aug 2010, and compared the clinical and pathological characteristics and long-term follow-up with 2220 patients with papillary thyroid carcinoma (PTC). These ten ITC cases comprised 7 women and 3 men, of whom 6 patients are multifocal ITC (mITC) and showed cervical lymph node metastasis to the lateral compartment, while the other 4 solitary ITC (sITC) had regional metastasis confined to level VI or even no cervical metastasis. The ITC group had more frequent retrosternal metastasis (40% vs. 7.5%), recurrent laryngeal nerve invasion (40% vs. 4.4%), esophageal invasion (50% vs. 1.9%), a higher proportion of distant metastasis (50% vs. 3.2%), and vascular invasion (50% vs. 1.0%). While the presence of lymph node metastasis showed no significant difference. Interestingly, although patients with ITC are lacking in number to perform survival analysis, we still noticed that all the four sITC patients (4/4, 100%) have survived much longer (at least 45 months) than those who have multinodularity (mITC, 5/6, 83.3%). Our results indicated that ITC is an aggressive disease and the presence of multifocality might be a risk factor for long time survival of ITC patients.
甲状腺内癌（ITC）是一种罕见的甲状腺恶性肿瘤，其侵袭性和局部复发倾向使其有别于其他甲状腺恶性肿瘤。然而，关于其临床特征的数据仍然匮乏。在本研究中，我们回顾性分析了2007年4月至2010年8月期间在天津医科大学肿瘤医院接受治疗及随访的10例ITC患者，并将其临床和病理特征以及长期随访情况与2220例甲状腺乳头状癌（PTC）患者进行了比较。这10例ITC病例包括7名女性和3名男性，其中6例为多灶性ITC（mITC），表现为颈部侧方淋巴结转移，而另外4例孤立性ITC（sITC）的区域转移局限于Ⅵ区，甚至无颈部转移。ITC组胸骨后转移更为常见（40% 对7.5%）、喉返神经侵犯更为常见（40% 对4.4%）、食管侵犯更为常见（50% 对1.9%）、远处转移比例更高（50% 对3.2%）以及血管侵犯更为常见（50% 对1.0%）。而淋巴结转移情况无显著差异。有趣的是，尽管ITC患者数量不足以进行生存分析，但我们仍注意到，所有4例sITC患者（4/4，100%）的生存时间均比多灶性患者（mITC，5/6，83.3%）长得多（至少45个月）。我们的结果表明，ITC是一种侵袭性疾病，多灶性的存在可能是ITC患者长期生存的一个危险因素。
