Ou Di, Ni Chen, Yao Jincao, Lai Min, Chen Chen, Zhang Yajiao, Jiang Tian, Qian Tingting, Wang Liping, Xu Dong
Department of Ultrasonography, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.
Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, China.
Front Oncol. 2022 Aug 16;12:956289. doi: 10.3389/fonc.2022.956289. eCollection 2022.
To analyze the clinical features, ultrasonographic manifestations, pathological features, treatment and prognosis of primary thyroid squamous cell carcinoma (PSCTC) and summarize the experience in diagnosis and treatment of this condition.
A retrospective analysis was conducted on patients who were admitted to Zhejiang Cancer Hospital from 2007 to 2021 due to thyroid nodules or thyroid malignant tumors that were ultimately confirmed by postoperative pathology as primary thyroid squamous cell carcinoma. We summarize the general situation, clinical information, laboratory examination, ultrasonic image characteristics, pathological examination, clinical treatment and prognosis of the patients.
PSCTC is most often seen in older men and progresses rapidly. In laboratory tests, some patients had elevated levels of tumor markers (CA199, squamous cell carcinoma antigen level), thyroglobulin levels and tumor-related substances, but all these indicators lacked specificity. The ultrasound features of PSCTC are mainly hypoechoic, hard, substantial nodules with gross borders and a grade 1-2 blood flow signal, sometimes with signs of necrosis and calcification. In terms of treatment, PSCTC is mainly surgically resected, though some patients in this study underwent iodine-131 radiation therapy, local radiotherapy, and chemotherapy with unclear results. None of the patients survived for very long after treatment, but the prognosis of patients with highly differentiated squamous carcinoma was significantly better than that of patients with poorly differentiated squamous carcinoma. Papillary thyroid carcinoma may be one of the causes of PSCTC.
PSCTC is a malignant tumor with high malignancy and rapid clinical progression. Treatment options are mainly based on surgical resection and can be supplemented with radiotherapy and chemotherapy, but there is still a lack of a standardized treatment management system, and more cases and reports are needed to accumulate data.
分析原发性甲状腺鳞状细胞癌（PSCTC）的临床特征、超声表现、病理特征、治疗及预后情况，总结该病的诊治经验。
对2007年至2021年因甲状腺结节或甲状腺恶性肿瘤入住浙江省肿瘤医院，术后病理最终确诊为原发性甲状腺鳞状细胞癌的患者进行回顾性分析。总结患者的一般情况、临床资料、实验室检查、超声图像特征、病理检查、临床治疗及预后情况。
PSCTC多见于老年男性，进展迅速。实验室检查中，部分患者肿瘤标志物（CA199、鳞状细胞癌抗原水平）、甲状腺球蛋白水平及肿瘤相关物质水平升高，但这些指标均缺乏特异性。PSCTC的超声特征主要为低回声、质地硬、实性结节，边界清晰，血流信号为1-2级，有时伴有坏死及钙化征象。治疗方面，PSCTC主要采取手术切除，本研究中部分患者接受了碘-131放射治疗、局部放疗及化疗，但效果不明确。治疗后患者均未长期存活，但高分化鳞状癌患者的预后明显优于低分化鳞状癌患者。甲状腺乳头状癌可能是PSCTC的病因之一。
PSCTC是一种恶性程度高、临床进展快的恶性肿瘤。治疗方案主要以手术切除为主，可辅以放疗及化疗，但仍缺乏标准化的治疗管理体系，需要更多病例及报道来积累数据。
