Yamazaki Haruhiko, Katoh Ryohei, Sugino Kiminori, Matsuzu Kenichi, Masaki Chie, Akaishi Junko, Hames Kiyomi Yamada, Tomoda Chisato, Suzuki Akifumi, Ohkuwa Keiko, Kitagawa Wataru, Nagahama Mitsuji, Rino Yasushi, Ito Koichi
Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan.
Department of Pathology, Ito Hospital, Shibuya-ku, Tokyo, Japan.
Ann Surg Oncol. 2022 Feb 15. doi: 10.1245/s10434-022-11401-x.
Previous studies have reported an association between four or more foci of vascular invasion (VI) and thyroid cancer prognosis, while the current study aimed to investigate the association between extent of VI and outcome of encapsulated angioinvasive follicular thyroid carcinoma (FTC).
The records of 303 patients with encapsulated angioinvasive FTC confirmed by surgical specimens at Ito Hospital from January 2005 to December 2014 were retrospectively reviewed. Thirteen patients had distant metastasis at diagnosis and were classified as M1.
Among the 290 patients with M0 encapsulated angioinvasive FTC, the 10-year disease-free survival (DFS) rate was 85.6%. Those with a VI of 1 (n = 131) or ≥ 2 (n = 159) had a 10-year DFS rate of 94.9% and 77.9% (p < 0.001), respectively, and those with a VI of 1-3 (n = 211) or ≥ 4 (n = 79) had a 10-year DFS rate of 86.3% and 83.3% (p = 0.311), respectively. Multivariate analysis identified age ≥ 55 years (p = 0.031) and VI ≥ 2 (p = 0.002) as independent negative prognostic factors for DFS. Patients with M0 encapsulated angioinvasive FTC aged ≥ 55 years and VI ≥ 2 had significantly poorer prognosis and a 10-year DFS rate of 66.4% (p < 0.001).
Patients with encapsulated angioinvasive FTC who had two or more foci of VI, especially patients aged ≥ 55 years, should be carefully followed-up.
既往研究报道血管侵犯（VI）四个或更多病灶与甲状腺癌预后相关，而本研究旨在探讨VI范围与包膜内血管侵犯性滤泡状甲状腺癌（FTC）预后的关系。
回顾性分析2005年1月至2014年12月在伊藤医院经手术标本确诊的303例包膜内血管侵犯性FTC患者的记录。13例患者诊断时已有远处转移，归类为M1。
在290例M0包膜内血管侵犯性FTC患者中，10年无病生存率（DFS）为85.6%。VI为1个（n = 131）或≥2个（n = 159）的患者10年DFS率分别为94.9%和77.9%（p < 0.001），VI为1 - 3个（n = 211）或≥4个（n = 79）的患者10年DFS率分别为86.3%和83.3%（p = 0.311）。多因素分析确定年龄≥55岁（p = 0.031）和VI≥2（p = 0.002）为DFS的独立负性预后因素。年龄≥55岁且VI≥2的M0包膜内血管侵犯性FTC患者预后明显较差，10年DFS率为66.4%（p < 0.001）。
有两个或更多VI病灶的包膜内血管侵犯性FTC患者，尤其是年龄≥55岁的患者，应密切随访。
