Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2022 Apr;69(4):262-270. doi: 10.1016/j.endien.2022.03.003. Epub 2022 Mar 16.
Familial non-medullary thyroid carcinoma (FNMTC) is defined by the presence of 2 or more first-degree family members with differentiated thyroid carcinoma (DTC). The aim of this study is to compare clinicopathological features and prognosis of FNMTC and sporadic carcinoma (SC).
Retrospective study of DTC included in the hospital database during the period 1990-2018.
A total of 927 patients were analyzed, 61 of them were FNMTC, with a mean follow-up of 9.7 ± 6.5 years. The prevalence of FNMTC was 6.6%, with a lower TNM staging presentation (P = 0.003) consequence of a higher proportion of tumors smaller than 2 cm (P = 0.003), combined with a greater multifocality (P = 0.034) and papillary histologic subtype (P = 0.022) compared to SC. No significant differences in age at diagnosis (P = 0.347), gender (P = 0.406), neither in other aggressiveness markers (bilaterality, extrathyroidal extension, lymph node involvement and metástasis) were detected. Rate of persistence/recurrence (P = 0.656), disease-free survival (P = 0.929) and mortality caused by the tumor itself (P = 0.666) were comparable. Families with ≥3 affected relatives, had smaller tumors (P = 0.005), more multifocality (P = 0.040) and bilaterality (P = 0.002), as well as a higher proportion of males (P = 0.020). Second generation patients present earlier FNMTC compared to those of the first generation (P = 0.001).
In our study FNMTC presents a lower TNM staging, higher multifocality and papillary variant, with similar aggressiveness and prognosis compared to SC.
家族性非髓样甲状腺癌(FNMTC)的定义是存在 2 个或更多一级亲属患有分化型甲状腺癌(DTC)。本研究的目的是比较 FNMTC 和散发性癌(SC)的临床病理特征和预后。
回顾性分析了 1990 年至 2018 年期间医院数据库中包含的 DTC 患者。
共分析了 927 例患者,其中 61 例为 FNMTC,平均随访 9.7±6.5 年。FNMTC 的患病率为 6.6%,表现为较低的 TNM 分期(P=0.003),这是由于肿瘤小于 2cm 的比例较高(P=0.003),同时伴有更多的多灶性(P=0.034)和乳头状组织学亚型(P=0.022)。与 SC 相比,FNMTC 在诊断时的年龄(P=0.347)、性别(P=0.406)以及其他侵袭性标志物(双侧性、甲状腺外延伸、淋巴结受累和转移)均无显著差异。持续性/复发率(P=0.656)、无疾病生存率(P=0.929)和肿瘤本身引起的死亡率(P=0.666)相当。有≥3 个受影响亲属的家族,肿瘤较小(P=0.005)、多灶性(P=0.040)和双侧性(P=0.002)的比例较高,且男性比例较高(P=0.020)。第二代患者的 FNMTC 发病较早,与第一代患者相比(P=0.001)。
在我们的研究中,与 SC 相比,FNMTC 的 TNM 分期较低,多灶性和乳头状变异程度较高,侵袭性和预后相似。