Department of Histopathology, St. James Hospital, Dublin, Ireland.
Department of Oral and Maxillofacial Surgery, Medicine and Pathology, Dublin Dental University Hospital, Dublin, Ireland.
Endocr Pathol. 2018 Sep;29(3):231-235. doi: 10.1007/s12022-018-9538-3.
The aim of this study was to determine the number of cases of papillary thyroid carcinoma (PTC) which could be reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in our institute over a 10-year period, document their clinical status and assess the number of slides that had to be reviewed per case to exclude NIFTP. The histopathology reports for thyroid resections for all papillary carcinoma over a 10-year period (2007-2016) were reviewed. Five hundred forty-five histopathology reports were reviewed, and 71 cases were identified as potential cases of NIFTP. Forty-nine (69%) cases had been referred from external departments and the slides were not available for review. Of the remaining 22 (31% of 71) cases, 5 were reclassified as NIFTP. The 17 cases that were not reclassified as NIFTP required review of 114 of 356 slides (median 5.5 slides per case) was required to exclude NIFTP. For the 5 NIFTP cases, 58 slides were reviewed (median 12 slides per case). We found that review of the histology reports alone was adequate for exclusion in most cases, e.g. classic PTC or EVPTC cases with documented lymphovascular invasion or capsular invasion. As a single exclusion criterion is required for exclusion from reclassification as NIFTP, this can be achieved efficiently. Two of the five patients received radioactive iodine [RAI] as per standard treatment at time of diagnosis, on the basis of tumour size. None have recurrent or metastatic disease with mean follow-up of 5.8 years.
本研究旨在确定在我们医院的 10 年期间，有多少例甲状腺乳头状癌（PTC）可重新归类为非浸润性滤泡性甲状腺肿瘤伴乳头状核特征（NIFTP），记录其临床状态，并评估每例病例需要审查多少张切片以排除 NIFTP。回顾了 10 年内（2007-2016 年）所有甲状腺切除术的甲状腺乳头状癌的组织病理学报告。共回顾了 545 份组织病理学报告，发现 71 例可能为 NIFTP。其中 49 例（69%）来自外部科室，切片无法进行审查。在其余的 22 例（71%的 71 例）中，有 5 例重新归类为 NIFTP。未重新归类为 NIFTP 的 17 例病例需要审查 356 张切片中的 114 张（中位数为每例 5.5 张）以排除 NIFTP。对于 5 例 NIFTP 病例，共审查了 58 张切片（中位数为每例 12 张）。我们发现，在大多数情况下，仅通过审查组织学报告即可排除，例如经典的 PTC 或有明确血管淋巴管侵犯或包膜侵犯的 EVPTC 病例。由于重新归类为 NIFTP 需要一个排除标准，因此可以有效地实现这一目标。这 5 例患者中的 2 例在诊断时根据肿瘤大小按标准治疗接受了放射性碘[RAI]治疗。随访 5.8 年，无复发病例或转移。
