Hong Jun Hwa, Yi Hyon-Seung, Yi Shinae, Kim Hyeon-Woo, Lee Junguee, Kim Koon Soon
Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea.
Research Centre for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea.
Clin Endocrinol (Oxf). 2016 Nov;85(5):797-804. doi: 10.1111/cen.13115. Epub 2016 Jul 1.
Although the presence of oncocytic change in less than 75% of a tumour is not considered to indicate oncocytic variants of papillary thyroid carcinoma (PTC), we frequently observe partial oncocytic change, especially in obese PTC patients. Thus, we sought to investigate the relationship between the presence of oncocytic change of PTC and its prognosis.
DESIGN, SETTING AND PARTICIPANTS: We retrospectively studied 142 patients with PTC who had undergone surgery between 2000 and 2005, and re-evaluated their PTC slides to record the proportion of oncocytic change in 10% increments from 0% to 100%.
We analysed the relationship between the proportion of oncocytic change and clinicopathological prognostic factors.
Oncocytic change was found in 45·8% (65/142) of PTC patients. The proportion of patients with oncocytic change was higher in obese patients than in lean patients and showed a significant correlation with the BMI (r = 0·195, P = 0·020). The PTC patients with oncocytic change showed a higher recurrence rate than PTC patients without oncocytic change (30·8% vs 11·7%, respectively; P = 0·005). The presence of oncocytic change in PTC patients was associated with a shorter disease-free survival in a Kaplan-Meier analysis after a mean follow-up of 8·9 years.
The patients with PTC with oncocytic change presented with a higher recurrence rate and were more likely to be obese. These findings suggest that presence of oncocytic change is a poor prognostic factor in PTC patients, even if the oncocytic change involves less than 75% of a tumour.
尽管肿瘤中嗜酸性变不足75%不被认为提示甲状腺乳头状癌（PTC）的嗜酸性细胞变异型，但我们经常观察到部分嗜酸性变，尤其是在肥胖的PTC患者中。因此，我们试图研究PTC嗜酸性变的存在与其预后之间的关系。
设计、背景与参与者：我们回顾性研究了2000年至2005年间接受手术的142例PTC患者，并重新评估他们的PTC切片，以记录嗜酸性变的比例，以10%的增量从0%到100%。
我们分析了嗜酸性变比例与临床病理预后因素之间的关系。
在45.8%（65/142）的PTC患者中发现了嗜酸性变。肥胖患者中出现嗜酸性变的比例高于瘦患者，且与BMI呈显著相关（r = 0.195，P = 0.020）。有嗜酸性变的PTC患者的复发率高于无嗜酸性变的PTC患者（分别为30.8%和11.7%；P = 0.005）。在平均随访8.9年后的Kaplan-Meier分析中，PTC患者中嗜酸性变的存在与无病生存期缩短相关。
有嗜酸性变的PTC患者复发率较高，且更可能肥胖。这些发现表明，即使嗜酸性变累及肿瘤不足75%，嗜酸性变的存在也是PTC患者预后不良的一个因素。
