Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, China.
Jpn J Clin Oncol. 2022 Nov 3;52(11):1311-1320. doi: 10.1093/jjco/hyac119.
To investigate the invasive capability and other clinicopathological features of conventional papillary thyroid carcinoma (CVPTC) with intraglandular lymphatic dissemination.
Seventy-three conventional papillary thyroid carcinoma patients receiving total thyroidectomy were analyzed in this study. The expression of BRAF-V600E, D2-40 and CD31 in all thyroid samples was detected by immunohistochemical staining. The results were evaluated by two pathologists and were statistically analyzed. The rate of positive BRAF-V600E expression and the clinical invasiveness of CVPTC with intraglandular dissemination, multifocal non-intraglandular dissemination-CVPTC and single focus-CVPTC were evaluated. The correlation between BRAF-V600E expression, lymphatic vessel density, microvessel density and the clinicopathological characteristics of conventional papillary thyroid carcinoma were assessed.
Twenty-five intraglandular dissemination-CVPTC, 17 multifocal non-intraglandular dissemination-CVPTC and 31 single focus-CVPTC cases were included in this study. The results showed that BRAF-V600E expression was independently correlated with intraglandular dissemination, age and pN staging (P < 0.05). The lymphatic vessel density in the intraglandular dissemination-CVPTC group was higher than that in the non-intraglandular dissemination-CVPTC group (P < 0.05). Compared with cases without intraglandular dissemination, intraglandular dissemination-CVPTC was associated with a younger age, higher lymph node metastasis rate, pN staging, the expression of BRAF-V600E and increased Capsule invasion and lymphovascular tumor thrombus (P < 0.05). During the follow-up of 30 months (median 15 months), two patients in the intraglandular dissemination-CVPTC group had cervical lymph node metastasis after the first operation.
Intraglandular dissemination-CVPTC shows more aggressive features, and intraglandular lymphatic dissemination may be a potential biological indicator of poor prognosis.
研究甲状腺内淋巴管播散的常规型甲状腺乳头状癌（CVPTC）的侵袭能力和其他临床病理特征。
本研究分析了 73 例行甲状腺全切除术的常规型甲状腺乳头状癌患者。所有甲状腺样本均通过免疫组织化学染色检测 BRAF-V600E、D2-40 和 CD31 的表达。由两位病理学家评估结果，并进行统计学分析。评估 CVPTC 甲状腺内播散、多灶性非甲状腺内播散-CVPTC 和单灶-CVPTC 中 BRAF-V600E 表达阳性率和 CVPTC 的临床侵袭性。评估 BRAF-V600E 表达与常规型甲状腺乳头状癌的淋巴管密度、微血管密度和临床病理特征的相关性。
本研究纳入了 25 例甲状腺内播散-CVPTC、17 例多灶性非甲状腺内播散-CVPTC 和 31 例单灶-CVPTC 病例。结果表明，BRAF-V600E 表达与甲状腺内播散、年龄和 pN 分期独立相关（P<0.05）。甲状腺内播散-CVPTC 组的淋巴管密度高于非甲状腺内播散-CVPTC 组（P<0.05）。与无甲状腺内播散的病例相比，甲状腺内播散-CVPTC 与更年轻的年龄、更高的淋巴结转移率、pN 分期、BRAF-V600E 表达以及增加的包膜侵犯和血管淋巴管瘤栓有关（P<0.05）。在 30 个月（中位数 15 个月）的随访期间，甲状腺内播散-CVPTC 组的 2 例患者在首次手术后出现颈部淋巴结转移。
甲状腺内播散-CVPTC 表现出更具侵袭性的特征，甲状腺内淋巴管播散可能是预后不良的潜在生物学指标。
