Giani C, Torregrossa L, Piaggi P, Matrone A, Viola D, Molinaro E, Agate L, Romei C, Ugolini C, De Napoli L, Materazzi G, Basolo F, Elisei R
Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56124, Pisa, Italy.
Pathology Unit, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124, Pisa, Italy.
Endocrine. 2020 Jun;68(3):607-616. doi: 10.1007/s12020-020-02229-0. Epub 2020 Mar 2.
To compare the epidemiological, clinical, and pathological features of follicular (FVPTC) and classical (CVPTC) variants of papillary thyroid cancer and to correlate their outcomes according to different features.
Retrospective analysis of FVPTC and CVPTC patients selected at the moment of surgical treatment from 1999 to 2004, with a median follow-up of 15 years.
Several significant differences were found between FVPTC and CVPTC such as the mean age at diagnosis, the presence of tumor capsule, the presence of thyroid capsule invasion, the presence of perithyroid soft tissue invasion, the lymph node metastases, the multifocality and bilaterality. At the end of follow-up only 9% (77/879) patients were not cured. However, a statistically significant lower percentage of persistent disease was found in the FVPTC than in the CVPTC group (3% vs. 14.5%, respectively, p < 0.0001). In multivariate analysis, the absence of the tumor capsule (OR = 6.75) or its invasion (OR = 7.89), the tumor size ≥4 cm (OR = 4.29), the variant CVPTC (OR = 3.35), and the presence of lymph node metastases (OR = 3.16) were all independent risk factors for the persistence of the disease.
Despite an overall excellent prognosis of both variants, a higher percentage of CVPTC than FVPTC patients had a persistent disease. The absence of tumor capsule or its invasion, the tumor size ≥4 cm and the presence of lymph node metastases are other prognostic factors for the persistence of the disease. In contrast, the presence of an intact tumor capsule is the only good prognostic factor for their outcome.
比较甲状腺乳头状癌滤泡型（FVPTC）和经典型（CVPTC）的流行病学、临床及病理特征，并根据不同特征关联其预后。
对1999年至2004年手术治疗时选取的FVPTC和CVPTC患者进行回顾性分析，中位随访时间为15年。
FVPTC和CVPTC之间发现了几个显著差异，如诊断时的平均年龄、肿瘤包膜的存在、甲状腺包膜侵犯的存在、甲状腺周围软组织侵犯的存在、淋巴结转移、多灶性和双侧性。随访结束时，仅有9%（77/879）的患者未治愈。然而，FVPTC组持续性疾病的百分比在统计学上显著低于CVPTC组（分别为3%和14.5%，p < 0.0001）。多因素分析中，无肿瘤包膜（OR = 6.75）或其侵犯（OR = 7.89）、肿瘤大小≥4 cm（OR = 4.29）、CVPTC变异型（OR = 3.35）以及存在淋巴结转移（OR = 3.16）均为疾病持续存在的独立危险因素。
尽管两种变异型总体预后良好，但CVPTC患者持续性疾病的百分比高于FVPTC。无肿瘤包膜或其侵犯、肿瘤大小≥4 cm以及存在淋巴结转移是疾病持续存在的其他预后因素。相反，完整肿瘤包膜的存在是其预后的唯一良好因素。
