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具有乳头状核特征的非侵袭性滤泡性甲状腺肿瘤:日本单机构经验

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a single-institutional experience in Japan.

作者信息

Hirokawa Mitsuyoshi, Higuchi Miyoko, Suzuki Ayana, Hayashi Toshitetsu, Kuma Seiji, Miyauchi Akira

机构信息

Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe 650-0011, Japan.

Department of Laboratory Medicine, Kuma Hospital, Kobe 650-0011, Japan.

出版信息

Endocr J. 2017 Dec 28;64(12):1149-1155. doi: 10.1507/endocrj.EJ17-0214. Epub 2017 Sep 12.

Abstract

Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (PTC) was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). To date, no studies on NIFTP have been reported in Japan. This study aimed to evaluate the clinical, cytological, and pathological findings of 54 cases of NIFTP from a single center in Japan, and compare them with those in the western countries. There were no significant differences in age, sex, or tumor size between patients with NIFTP and those with invasive encapsulated follicular variant -PTC. Ultrasound investigation showed a high suspicion lesion in 6.5% of NIFTP and 44.1% of invasive encapsulated follicular variant -PTC (p<0.001). On fine needle aspiration cytology, 75.7% of NIFTP cases were reported as suspicious for malignancy or malignant. Nuclear grooves and irregular-shaped nuclei were observed in 94.6% of cases of NIFTP. Pathologically, 27.8% cases of NIFTP and 13.0% cases of invasive encapsulated follicular variant -PTC had been originally diagnosed as macrofollicular variants of PTC. There were no NIFTP cases with nodal metastasis. We concluded that NIFTP should be renounced noninvasive encapsulated follicular variant -PTC, and should be considered as a malignant tumor with exceeding indolent behavior, and lobectomy alone should be satisfactory for the diagnosis and treatment.

摘要

甲状腺乳头状癌(PTC)的非侵袭性包裹性滤泡变体被重新分类为具有乳头状核特征的非侵袭性滤泡性甲状腺肿瘤(NIFTP)。迄今为止,日本尚未有关于NIFTP的研究报道。本研究旨在评估来自日本单一中心的54例NIFTP的临床、细胞学和病理学表现,并将其与西方国家的情况进行比较。NIFTP患者与侵袭性包裹性滤泡变体PTC患者在年龄、性别或肿瘤大小方面无显著差异。超声检查显示,6.5%的NIFTP和44.1%的侵袭性包裹性滤泡变体PTC有高度可疑病变(p<0.001)。在细针穿刺细胞学检查中,75.7%的NIFTP病例被报告为可疑恶性或恶性。94.6%的NIFTP病例观察到核沟和不规则形核。病理上,27.8%的NIFTP病例和13.0%的侵袭性包裹性滤泡变体PTC病例最初被诊断为PTC的大滤泡变体。没有NIFTP病例发生淋巴结转移。我们得出结论,NIFTP应摒弃非侵袭性包裹性滤泡变体PTC的称呼,应被视为一种行为极其惰性的恶性肿瘤,仅行肺叶切除术对于诊断和治疗应是足够的。

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