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甲状腺髓样癌和乳头状癌并存患者的临床病理特征及预后

Clinicopathological features and outcomes in patients with concurrent medullary and papillary thyroid carcinoma.

作者信息

Sun Ruonan, Liu Xueting, Liu Jiabin, Li Zhihui, Wang Yichao

机构信息

Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Endocrinol (Lausanne). 2025 Aug 11;16:1625989. doi: 10.3389/fendo.2025.1625989. eCollection 2025.

Abstract

OBJECTIVE

The co-existence of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) is rare. The study analyzed the clinicopathological findings and prognosis of concomitant PTC in MTC patients.

METHODS

Clinicopathological data and follow-up outcomes of 25 patients with concurrent medullary and papillary thyroid carcinoma (combination group) between January 2009 and May 2024 were collected and analyzed retrospectively. We compared clinicopathologic characteristics and follow-up outcomes between patients with concurrent MTC and PTC (combination group) and those with MTC alone (MTC group).

RESULTS

The 25 patients with concurrent MTC and PTC comprised 19 females and 6 males. There were no statistically significant differences between the combination group and the MTC group in terms of age, gender, or pathological features such as the diameter of MTC lesions, multifocality, extra-thyroidal extension (ETE), number of lymph node (LN) resected, the number of LN metastasis, the maximum diameter of LN metastasis, and TNM staging. The recurrence rate was similar between the two groups. Univariate analysis showed that the max tumor diameter, capsule invasion, extracapsular invasion and recurrent nerve invasion were associated with the risk of biochemical/structural abnormalities in MTC group. Multivariate analysis showed that only the max tumor diameter and capsule invasion were significant independent prognostic factors for biochemical/structural abnormalities.

CONCLUSION

The result of this comparative study between patients with MTC and PTC co-existence and those with MTC alone showed similar invasiveness and prognosis.

摘要

目的

甲状腺髓样癌(MTC)与甲状腺乳头状癌(PTC)并存的情况较为罕见。本研究分析了MTC患者合并PTC的临床病理特征及预后。

方法

回顾性收集并分析2009年1月至2024年5月期间25例同时患有甲状腺髓样癌和乳头状癌患者(联合组)的临床病理数据及随访结果。我们比较了同时患有MTC和PTC的患者(联合组)与单纯患有MTC的患者(MTC组)的临床病理特征及随访结果。

结果

25例同时患有MTC和PTC的患者中,女性19例,男性6例。联合组与MTC组在年龄、性别或病理特征方面,如MTC病变直径、多灶性、甲状腺外侵犯(ETE)、切除淋巴结数量、淋巴结转移数量、淋巴结转移最大直径及TNM分期等,均无统计学显著差异。两组的复发率相似。单因素分析显示,最大肿瘤直径、包膜侵犯、包膜外侵犯及喉返神经侵犯与MTC组生化/结构异常风险相关。多因素分析显示,只有最大肿瘤直径和包膜侵犯是生化/结构异常的显著独立预后因素。

结论

本项MTC与PTC并存患者与单纯MTC患者的对比研究结果显示,两者的侵袭性和预后相似。

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Medullary thyroid carcinoma.甲状腺髓样癌
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Lancet. 2023 May 6;401(10387):1531-1544. doi: 10.1016/S0140-6736(23)00020-X. Epub 2023 Apr 3.
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Thyroid cancer, recent advances in diagnosis and therapy.甲状腺癌:诊断与治疗的新进展。
Int J Cancer. 2021 Sep 1;149(5):984-992. doi: 10.1002/ijc.33690. Epub 2021 May 29.

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