Nuclear medicine-thyroid Unit, Institut Godinot, 1, rue du Général-Koenig, 51100 Reims, France.
Thyroid Cancer Registry of Marne-Ardennes, Institut Godinot, 1, rue du Général-Koenig, 51100 Reims, France.
Ann Endocrinol (Paris). 2020 Feb;81(1):34-38. doi: 10.1016/j.ando.2019.12.001. Epub 2020 Jan 25.
Non-invasive forms of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) were reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in order to reduce overtreatment. A few studies showed neck lymphadenopathy at diagnosis, or even distant metastasis in patients with NIFTP.
Our aim was to report the frequency, clinical features and long-term progression of histologically confirmed NIFTP, using data from the French Marne-Ardennes thyroid cancer registry, and to compare findings against FVPTC.
This was a retrospective study on data for follicular variant of PTC (FVPTC) diagnosed between 1975 and 2015 obtained from the specialized Marne-Ardennes thyroid cancer registry. Pathology reports were used to select appropriate cases from a large series, and FVPTC specimens were reviewed by endocrine pathologists. Strict diagnostic criteria were used for reclassification as NIFTP.
In total, 115 cases were reviewed histologically out of 383 cases of FVPTC. Sixty-five met all criteria for NIFTP and were consequently reclassified. Incidence of NIFTP was 16.9% of cases of FVPTC. Fifty patients were women (76.9%); median age was 47 years. Mean NIFTP size was 2.6 cm. There were no significant differences in age, gender or tumor size between NIFTP and FVPTC. Fifty patients underwent total thyroidectomy and 15 lobectomy. There were no lymph node metastases at diagnosis, and none of the patients (N=17) who underwent central and/or lateral neck dissection had positive findings on microscopic examination. 46 patients (70.8%) received radioiodine (RAI). Patients were followed up for 1.9-27.3 years (median 14.6 years) after initial treatment. All patients remained in complete remission during follow-up.
Consistently with previous studies, our results showed the indolent course of NIFTP and that risk of recurrence after complete resection is very low (zero in our cohort), even when size is ≥4cm and in absence of adjuvant RAI treatment. Prospective studies are needed to confirm those results.
为了减少过度治疗，将非侵袭性包裹滤泡型甲状腺乳头状癌（EFVPTC）重新分类为具有滤泡状肿瘤乳头状核特征的非侵袭性滤泡性甲状腺肿瘤（NIFTP）。一些研究表明，NIFTP 患者在诊断时存在颈部淋巴结病，甚至远处转移。
本研究旨在通过法国马恩-阿登甲状腺癌登记处的数据，报告组织学证实的 NIFTP 的频率、临床特征和长期进展，并与 FVPTC 进行比较。
这是一项回顾性研究，对 1975 年至 2015 年期间从专门的马恩-阿登甲状腺癌登记处获得的滤泡状甲状腺癌（FVPTC）诊断数据进行了研究。使用病理学报告从大量系列中选择合适的病例，由内分泌病理学家审查 FVPTC 标本。使用严格的诊断标准将其重新分类为 NIFTP。
共对 383 例 FVPTC 中的 115 例进行了组织学回顾。65 例符合 NIFTP 的所有标准，因此被重新分类。NIFTP 的发生率为 FVPTC 的 16.9%。50 例患者为女性（76.9%）；中位年龄为 47 岁。平均 NIFTP 大小为 2.6cm。NIFTP 和 FVPTC 之间在年龄、性别或肿瘤大小方面无显著差异。50 例患者接受了全甲状腺切除术，15 例接受了甲状腺叶切除术。诊断时无淋巴结转移，17 例接受中央和/或侧颈部淋巴结清扫术的患者显微镜检查未见阳性发现。46 例（70.8%）接受放射性碘（RAI）治疗。患者在初始治疗后随访 1.9-27.3 年（中位随访 14.6 年）。在随访期间，所有患者均处于完全缓解状态。
与先前的研究一致，我们的结果表明 NIFTP 的病程呈惰性，即使在完全切除后，复发风险也非常低（在我们的队列中为零），即使肿瘤大小≥4cm 且不进行辅助 RAI 治疗。需要前瞻性研究来证实这些结果。
