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甲状腺乳头状癌的非侵袭性包裹性滤泡变体:基于社区的内分泌外科实践的临床经验

Noninvasive Encapsulated Follicular Variant of Papillary Thyroid Cancer: Clinical Lessons from a Community-Based Endocrine Surgical Practice.

作者信息

Golding Allan, Shively Dana, Bimston David N, Harrell R Mack

机构信息

Department of Endocrine Surgery, Memorial Hospital System, Hollywood, FL, USA.

The Department of Undergraduate Studies, The University of Florida, Gainesville, FL, USA.

出版信息

Int J Surg Oncol. 2017;2017:4689465. doi: 10.1155/2017/4689465. Epub 2017 Apr 13.

DOI:10.1155/2017/4689465
PMID:28487771
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5406735/
Abstract

. Retrospective studies have found that noninvasive encapsulated follicular variant of papillary thyroid cancer (EFVPTC) exhibits highly indolent clinical behavior. We studied the clinical features of our patients with noninvasive EFVPTC tumors culled from a community endocrine surgical practice registry over the past four years. . We interrogated the Memorial Center for Integrative Endocrine Surgery (MCIES) Registry for all recorded encapsulated follicular variant of papillary cancer pathologic diagnoses. We identified a subgroup of patients without capsular or vascular invasion and studied their clinical characteristics. . Thirty-seven patients met inclusion and exclusion criteria. The typical patient was young and female. Nodules averaged 3.1 cm in greatest dimension by ultrasound evaluation. Thirteen patients were found to have synchronous malignancies elsewhere in the thyroid (35%). At the time of this writing, we have not seen a clinical recurrence in any of our 37 noninvasive EFVPTC patients. . Early clinical follow-up data suggests that the majority of noninvasive EFVPTC tumors exhibit indolent behavior, but clinical decision-making with regard to completion thyroidectomy, central lymph node dissection, and adjunctive radioiodine therapy often depends on the amount and type of synchronous thyroid cancer detected elsewhere in the thyroid gland and the central neck.

摘要

回顾性研究发现,甲状腺乳头状癌的非侵袭性包膜滤泡变体(EFVPTC)表现出高度惰性的临床行为。我们研究了过去四年从社区内分泌外科实践登记处挑选出的非侵袭性EFVPTC肿瘤患者的临床特征。我们查询了纪念综合内分泌外科中心(MCIES)登记处所有记录的包膜滤泡变体乳头状癌病理诊断。我们确定了一组无包膜或血管侵犯的患者,并研究了他们的临床特征。37名患者符合纳入和排除标准。典型患者为年轻女性。通过超声评估,结节最大直径平均为3.1厘米。13名患者被发现甲状腺其他部位存在同步性恶性肿瘤(35%)。在撰写本文时,我们的37名非侵袭性EFVPTC患者中尚未出现临床复发。早期临床随访数据表明,大多数非侵袭性EFVPTC肿瘤表现出惰性行为,但关于甲状腺全切术、中央淋巴结清扫术和辅助放射性碘治疗的临床决策通常取决于在甲状腺和中央颈部其他部位检测到的同步性甲状腺癌的数量和类型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64e7/5406735/d1d345baa8af/IJSO2017-4689465.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64e7/5406735/d1d345baa8af/IJSO2017-4689465.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64e7/5406735/d1d345baa8af/IJSO2017-4689465.001.jpg

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JAMA Oncol. 2016 Aug 1;2(8):1023-9. doi: 10.1001/jamaoncol.2016.0386.
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2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.
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Performance of a Genomic Sequencing Classifier for the Preoperative Diagnosis of Cytologically Indeterminate Thyroid Nodules.基因组测序分类器在术前诊断细胞学不确定的甲状腺结节中的性能。
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