Dell'Aquila Marco, Tralongo Pietro, De Ruggieri Giuseppe, Curatolo Mariangela, Revelli Luca, Lombardi Celestino Pio, Pontecorvi Alfredo, Fadda Guido, Larocca Luigi Maria, Raffaelli Marco, Pantanowitz Liron, Rossi Esther Diana
Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00168 Rome, Italy.
Division of Endocrine Surgery, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00168 Rome, Italy.
J Pers Med. 2022 Feb 5;12(2):221. doi: 10.3390/jpm12020221.
Despite the fact that the majority of thyroid cancers are indolent, 15% of patients with well-differentiated carcinoma including papillary thyroid carcinoma (PTC) present with locally advanced thyroid cancer (LATC) at diagnosis. The current study analyzes a cohort of patients with LATC focusing on their risk for local recurrence, distant metastases, and overall survival.
From January 2010 to December 2020, 65 patients with LATC were retrieved, including 42 cases with preoperative cytological samples. and mutations were performed on both cytology and histopathology specimens in this cohort.
Among the 65 cases, 42 (65%) were women. The median age was 60.1 years. Histological diagnoses included 25 (38.4%) with classic PTC and 30 (46.1%) aggressive variants of PTC, mostly tall cell variant (17 cases, 26.1%). Multifocality was seen in 33 cases (50.8%). All patients had nodal metastases. The most common site of extrathyroidal extension was the recurrent laryngeal nerve (69.2%). Staging revealed 21 cases were stage I, none were stage II, 33 were stage III, and 7 were stage IVa and 4 stage IVb. No differences were found between well and poorly/undifferentiated thyroid cancers.
These data suggest that locally advanced thyroid cancers, including variants of PTC, exhibit a more aggressive biological course and should accordingly be more assertively managed.
尽管大多数甲状腺癌生长缓慢，但包括甲状腺乳头状癌（PTC）在内的15%的分化型甲状腺癌患者在诊断时表现为局部晚期甲状腺癌（LATC）。本研究分析了一组LATC患者，重点关注其局部复发、远处转移和总生存风险。
2010年1月至2020年12月，共纳入65例LATC患者，其中42例有术前细胞学样本。对该队列中的细胞学和组织病理学标本均进行了 和 突变检测。
65例患者中，42例（65%）为女性。中位年龄为60.1岁。组织学诊断包括25例（38.4%）经典型PTC和30例（46.1%）PTC侵袭性变异型，主要为高细胞变异型（17例，26.1%）。33例（50.8%）为多灶性。所有患者均有淋巴结转移。甲状腺外侵犯最常见的部位是喉返神经（69.2%）。分期显示，21例为I期，无II期患者，33例为III期，7例为IVa期，4例为IVb期。在分化良好与分化差/未分化的甲状腺癌之间未发现差异。
这些数据表明，包括PTC变异型在内的局部晚期甲状腺癌具有更具侵袭性的生物学进程，因此应采取更积极的治疗措施。
