Myshunina T M, Guda B D, Bolgov M Yu, Mikhailenko N I, Tronko N D
State Institution "V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv 04114, Ukraine.
Exp Oncol. 2018 Jun;40(2):128-131.
To determine biological and clinical features of papillary and follicular thyroid carcinomas associated or not associated with chronic thyroiditis.
The study was conducted by retrospective analysis of medical histories of 2,459 patients with thyroid cancer. Tumor size, its category according to the TNM system, multi-focal properties of tumor growth, carcinoma invasiveness, as well as disease stage, rates of relapses and metastasis, and also cumulative survival rates were analyzed.
The tumor size in patients with papillary or follicular carcinoma associated with thyroiditis was smaller compared to the patients without thyroiditis. In the first case, the invasion frequency into extrathyroid structure and into the capsule was also lower. Multi-focal growth of both carcinoma types was registered more frequently in the presence of thyroiditis. The frequency of papillary carcinoma metastasis to lateral cervical lymph nodes was lower in the presence of thyroiditis, the frequency being equal for metastasis into lymph nodes of the VI lymph outflow zone in both groups of patients (with and without thyroiditis). In the presence of thyroiditis, the frequency of distant papillary carcinoma metastasis was decreased, no metastases were detected in patients with follicular carcinoma. In the group of patients with papillary carcinoma there was found no relation between the presence of thyroiditis and disease stage, relapse rates, and mortality levels; however, the risk of follicular carcinoma relapse was significantly lower in patients with thyroiditis.
The presence of chronic thyroiditis in papillary carcinoma patients showed a certain positive impact on the course of the disease, in particular, primary tumor growth, invasion, and metastasis. Such effect is even more expressed in the patients with follicular thyroid carcinoma.
确定伴或不伴慢性甲状腺炎的乳头状和滤泡状甲状腺癌的生物学及临床特征。
通过回顾性分析2459例甲状腺癌患者的病史进行本研究。分析肿瘤大小、根据TNM系统的分类、肿瘤生长的多灶性、癌浸润情况，以及疾病分期、复发率和转移率，还有累积生存率。
与无甲状腺炎的患者相比，伴甲状腺炎的乳头状或滤泡状癌患者的肿瘤较小。在第一种情况下，侵犯甲状腺外结构和包膜的频率也较低。两种类型的癌在存在甲状腺炎时多灶性生长更为常见。存在甲状腺炎时，乳头状癌转移至颈侧淋巴结的频率较低，两组患者（有和无甲状腺炎）转移至Ⅵ区淋巴引流区淋巴结的频率相同。存在甲状腺炎时，乳头状癌远处转移的频率降低，滤泡状癌患者未检测到转移。在乳头状癌患者组中，甲状腺炎的存在与疾病分期、复发率和死亡率之间未发现关联；然而，甲状腺炎患者滤泡状癌复发的风险显著较低。
乳头状癌患者存在慢性甲状腺炎对疾病进程有一定的积极影响，特别是对原发肿瘤生长、浸润和转移。这种影响在滤泡状甲状腺癌患者中更为明显。
