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切尔诺贝利事故影响地区甲状腺乳头状癌筛状梁状型的特征。

Characteristics of cribriform morular variant of papillary thyroid carcinoma in post-Chernobyl affected region.

机构信息

Discipline of Pathology, School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia.

Republican Centre for Thyroid Tumors, Nezavisimosty Av., 64, 220013 Minsk, Belarus.

出版信息

Hum Pathol. 2018 Apr;74:170-177. doi: 10.1016/j.humpath.2018.01.006. Epub 2018 Jan 7.

Abstract

The aim is to study the characteristics of cribriform morular variant of papillary thyroid carcinoma (CMV-PTC) in patients living in the radiation-affected area of Belarus. The clinical and pathological features of 35 patients with CMV-PTC from Belarus were studied and compared with those of conventional papillary thyroid carcinoma diagnosed in the same period. The patients with CMV-PTC were all females and were younger at presentation (mean age = 24) than those with conventional papillary thyroid carcinoma. Familial adenomatous polyposis (FAP) was identified in 20% of the patients with CMV-PTC. The majority of the CMV-PTCs (29/35; 83%) were staged as pT1 and were less advanced than conventional papillary thyroid carcinoma. There was no evidence of lymph node metastases or distant metastases. CMV-PTCs were positive for β-catenin, APC (adenomatous polyposis coli) and p53 proteins. No psammoma bodies were identified on microscopic examination. Over a median follow-up of 9 years, all the patients were alive, and there was no cancer recurrence or mortality related to the thyroid cancer. To conclude, CMV-PTC in patients in the radiation-affected region behaves in an indolent fashion. They had distinctive features that are different from patients with conventional papillary thyroid carcinoma living in the same region.

摘要

目的是研究白俄罗斯辐射影响地区患者的筛状和柱状甲状腺乳头状癌变异型(CMV-PTC)的特征。研究了 35 例来自白俄罗斯的 CMV-PTC 患者的临床和病理特征,并与同期诊断的常规甲状腺乳头状癌进行了比较。CMV-PTC 患者均为女性,且发病时年龄较小(平均年龄=24 岁),比常规甲状腺乳头状癌患者小。在 CMV-PTC 患者中,20%存在家族性腺瘤性息肉病(FAP)。大多数 CMV-PTC(29/35;83%)分期为 pT1,比常规甲状腺乳头状癌进展程度低。无淋巴结转移或远处转移的证据。CMV-PTC 对 β-连环蛋白、APC(结肠腺瘤性息肉病)和 p53 蛋白呈阳性。显微镜下未见砂粒体。在中位数为 9 年的随访中,所有患者均存活,且无与甲状腺癌相关的癌症复发或死亡。总之,辐射影响地区的患者的 CMV-PTC 表现为惰性。它们具有与同一地区的常规甲状腺乳头状癌患者不同的独特特征。

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