State Institution "V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv 04114, Ukraine.
Exp Oncol. 2023 Jun 26;45(1):70-78. doi: 10.15407/exp-oncology.2023.01.070.
Familial non-medullary thyroid carcinoma (FNMTC) is defined as cancer developing in two or more first-degree relatives if predisposing factors, for example, radiation, are absent. The disease can be either syndromic, when it is a component of complex genetic syndromes, or non-syndromic (95% cases). The genetic basis of non-syndromic FNMTC is unknown; the clinical behavior of tumorsis unclear and, at times, contradictory.
To analyze clinical manifestations of FNMTC and compare them with the data for sporadic papillary thyroid carcinomas in patients of the same age groups.
We examined 22 patients (a "parents" group and a "children" group) suffering from the non-syndromic FNMTC. For comparison, two groups of sporadic papillary carcinomas patients of the same age were drawn up("adult" and "young"). We analyzed tumor size and frequency of the distributionby the categoryof TNM system, invasiveness, multifocality, metastases to lymph nodes, type and extent of surgical and radioiodine treatment, and prognosis according to the MACIS criterion.
Whether sporadic or familial, the tumor size, metastatic potential, and invasive potential are higher in young people, asalready known. There was no significant difference between the "parents" and "adult" groups of patients in terms of tumor parameters. One exception was the higher frequency of multifocal tumors in the FNMTC patients. Meanwhile, compared to the "young" sporadic papillary carcinomas patients, the FNMTC "children" had a higher frequency of T2 tumors, metastasizing (N1a-N1ab), and multifocal tumors, but a lower frequency of carcinomas with intrathyroidal invasions.In the FNMTC "children" compared to FNMTC "parents" was a higher frequency of T2 tumors, metastasizing carcinomas, and tumors with capsular invasion.
FNMTC carcinomas are more aggressive than sporadic ones, especially in patients who are first-degree relatives in a family with parents already diagnosed with the disease.
家族性非髓样甲状腺癌(FNMTC)定义为在没有诱发因素(如辐射)的情况下,两个或两个以上一级亲属中发生的癌症。该疾病可能是综合征性的,即它是复杂遗传综合征的一部分,也可能是非综合征性的(95%的病例)。非综合征性 FNMTC 的遗传基础尚不清楚;肿瘤的临床行为尚不清楚,有时甚至相互矛盾。
分析 FNMTC 的临床表现,并将其与同年龄组散发性乳头状甲状腺癌患者的数据进行比较。
我们检查了 22 名患有非综合征性 FNMTC 的患者(“父母”组和“子女”组)。为了比较,我们还设立了两组同年龄的散发性乳头状癌患者(“成人”和“年轻人”)。我们分析了肿瘤大小和 TNM 系统分类的分布频率、侵袭性、多灶性、淋巴结转移、手术和放射性碘治疗的类型和范围,以及根据 MACIS 标准的预后。
无论是散发性还是家族性,年轻人的肿瘤大小、转移潜力和侵袭潜力都更高,这已经众所周知。在肿瘤参数方面,“父母”组和“成人”组患者之间没有显著差异。一个例外是 FNMTC 患者中多灶性肿瘤的频率较高。与此同时,与散发性乳头状癌“年轻人”相比,FNMTC“儿童”患者 T2 肿瘤、转移(N1a-N1ab)和多灶性肿瘤的频率更高,但甲状腺内浸润性癌的频率较低。在 FNMTC“儿童”中,与 FNMTC“父母”相比,T2 肿瘤、转移癌和包膜侵犯的肿瘤频率更高。
FNMTC 癌比散发性癌更具侵袭性,尤其是在一级亲属中有父母已被诊断患有该疾病的患者中。