混合性髓样甲状腺肿瘤的特征：NCDB 对临床病理特征和生存的分析。
Features of mixed medullary thyroid tumors: An NCDB analysis of clinicopathologic characteristics and survival.
机构信息
Department of Surgery, Cooper University Hospital, Camden, NJ, 01803, USA.
Cooper Research Institute, Cooper University Hospital, Camden, NJ, 01803, USA.
出版信息
Am J Surg. 2023 Jul;226(1):53-58. doi: 10.1016/j.amjsurg.2023.02.006. Epub 2023 Feb 10.
BACKGROUND
Mixed medullary-papillary thyroid carcinoma (MMPTC) and mixed medullary-follicular thyroid carcinoma (MMFTC) are rare variants with little known regarding behavior and prognosis.
METHODS
Using the National Cancer Database (NCDB), demographics, clinicopathologic features, treatment, and overall survival (OS) from patients with MMPTC and MMFTC were compared to more prevalent subtypes.
RESULTS
There were 296,101 patients: 421 MMPTC (0.14%), 133 MMFTC (0.04%), 263,140 PTC (88.87%), 24,208 FTC (8.18%) and 8,199 MTC (2.77%). Compared to PTC, MMPTC and MMFTC patients were older (p < 0.001) with a higher Charlson-Deyo comorbidity index (p < 0.001). Mixed tumors exhibited lower rates of nodal disease but more distant metastases compared to PTC (p < 0.001). MMPTC demonstrated lower estimated 10-year OS than PTC and FTC (76.04%vs 89.04% and 81.95%,p < 0.001), yet higher than MTC (70.29%,p < 0.001). MMFTC had a worse OS compared to all groups (63.32%,p < 0.001).
CONCLUSION
Patients with MMFTC had significantly worse OS compared to DTC, portending a worse prognosis.
背景
混合髓样-乳头型甲状腺癌（MMPTC）和混合髓样-滤泡型甲状腺癌（MMFTC）是罕见的变异型，其行为和预后知之甚少。
方法
利用国家癌症数据库（NCDB），比较 MMPTC 和 MMFTC 患者与更常见亚型的人口统计学、临床病理特征、治疗和总生存（OS）。
结果
共纳入 296101 例患者：421 例 MMPTC（0.14%）、133 例 MMFTC（0.04%）、263140 例 PTC（88.87%）、24208 例 FTC（8.18%）和 8199 例 MTC（2.77%）。与 PTC 相比，MMPTC 和 MMFTC 患者年龄更大（p<0.001），Charlson-Deyo 合并症指数更高（p<0.001）。混合肿瘤的淋巴结疾病发生率较低，但远处转移率高于 PTC（p<0.001）。MMPTC 的估计 10 年 OS 低于 PTC 和 FTC（76.04%比 89.04%和 81.95%，p<0.001），但高于 MTC（70.29%，p<0.001）。MMFTC 的 OS 较所有组别均差（63.32%，p<0.001）。
结论
与 DTC 相比，MMFTC 患者的 OS 明显更差，预示预后更差。
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