分化型甲状腺癌后发生的间变性癌：病因学思考。

Kapp D S, LiVolsi V A, Sanders M M

Yale J Biol Med. 1982 Sep-Dec;55(5-6):521-8.

Most cases of anaplastic thyroid carcinoma can be pathologically and often historically associated with the presence of low-grade (differentiated) cancer in the thyroid. That radiation therapy to the differentiated tumor plays an etiologic role in the transformation of a differentiated to an undifferentiated tumor has been suggested. If such therapy can be implicated, is there a difference in risk between external radiotherapy or radioactive iodine? Review of the literature discloses that more anaplastic carcinoma of the thyroid develop in patients without a history of prior radiation than in individuals who have received radiation. We report our recent experience with two patients who demonstrated the sequence of well-differentiated followed by anaplastic thyroid cancer subsequent to radiation and review the question.

大多数间变性甲状腺癌在病理上，且往往在病史方面与甲状腺存在低级别（分化型）癌有关。有人提出，对分化型肿瘤进行放射治疗在分化型肿瘤向未分化型肿瘤的转变中起病因学作用。如果这种治疗有牵连，那么外照射放疗或放射性碘之间的风险有差异吗？文献回顾显示，与接受过放疗的个体相比，既往无放疗史的患者发生更多的甲状腺间变性癌。我们报告了最近两名患者的经历，他们在放疗后出现了先分化良好随后发生间变性甲状腺癌的情况，并对这个问题进行了回顾。