Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98124, Messina, Italy.
Department of Pathology, Foundation "Agostino Gemelli", University Hospital IRCCS, 00168, Rome, Italy.
Endocrine. 2022 Oct;78(1):1-12. doi: 10.1007/s12020-022-03146-0. Epub 2022 Jul 21.
The incidence of thyroid carcinoma has increased globally in the past years. Papillary thyroid carcinoma (PTC) is the most frequent neoplasm of the thyroid gland comprehending the 90% of the thyroid carcinoma and has an indolent clinical behaviour. However, some variants of follicular cell-derived thyroid carcinoma, including variants of classic of PTC, have been identified that show a more aggressive biological behaviour. An accurate diagnosis of these entities is crucial for planning a more aggressive treatment and improving patients' prognosis of patients. The aim of this review is to present the main clinical, histological, and molecular features of aggressive variants of follicular cell-derived thyroid carcinoma, and to provide useful histological parameters for determining the most suitable therapeutic strategy for patients affected by these forms.
Variants of classic PTC such as the diffuse sclerosing variant (DSV), the tall cell variant (TCV), the columnar cell variant (CCV), the solid/trabecular variant (STV) and the hobnail variant (HV), and other variants of follicular cell-derived thyroid carcinoma, such as poorly differentiated thyroid carcinoma (PDTC), and anaplastic thyroid carcinoma (ATC), are associated with aggressive behaviour.
The correct identification and diagnosis of aggressive variants of follicular cell-derived thyroid carcinoma is important, as they allow the clinician to adopt the most refined therapeutic strategies in order to the survival of the patients.
近年来，全球甲状腺癌的发病率有所增加。甲状腺乳头状癌（PTC）是甲状腺最常见的肿瘤，占甲状腺癌的 90%，具有惰性的临床行为。然而，已经确定了一些滤泡细胞来源的甲状腺癌的变体，包括经典 PTC 的变体，这些变体表现出更具侵袭性的生物学行为。准确诊断这些实体对于规划更具侵袭性的治疗方案和改善患者预后至关重要。本综述的目的是介绍侵袭性滤泡细胞来源的甲状腺癌变体的主要临床、组织学和分子特征，并提供有用的组织学参数，以确定最适合这些形式患者的治疗策略。
经典 PTC 的变体，如弥漫性硬化变体（DSV）、高细胞变体（TCV）、柱状细胞变体（CCV）、实性/小梁状变体（STV）和钉状细胞变体（HV），以及其他滤泡细胞来源的甲状腺癌变体，如低分化甲状腺癌（PDTC）和间变性甲状腺癌（ATC），与侵袭性行为相关。
正确识别和诊断侵袭性滤泡细胞来源的甲状腺癌变体非常重要，因为它们可以让临床医生采用最精细的治疗策略，以提高患者的生存率。
