Tielens E T, Sherman S I, Hruban R H, Ladenson P W
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Cancer. 1994 Jan 15;73(2):424-31. doi: 10.1002/1097-0142(19940115)73:2<424::aid-cncr2820730230>3.0.co;2-i.
A retrospective clinicopathologic study was performed to identify the influence of diagnostic and therapeutic procedures on the outcomes of patients with the follicular variant of papillary thyroid carcinoma (FVPTC).
The results of 37 patients with FVPTC were compared with those of 37 randomly selected patients with papillary carcinoma and 22 patients with follicular carcinoma. Diagnostic, therapeutic, and follow-up data were obtained by review of clinical and histologic materials.
Median follow-up was approximately 3 years in all groups. Fine-needle aspiration had a sensitivity of 75% for FVPTC, which was similar to that for papillary carcinoma. Frozen section evaluation had a sensitivity of only 27% for FVPTC but 94% for papillary carcinoma and 44% for follicular carcinoma. All patients for whom the fine-needle aspiration specimen contained cytologic features of papillary carcinoma and frozen section suggested a follicular lesion proved to have FVPTC: Consequently, hemithyroidectomy was performed three times more often among patients with FVPTC than among those with papillary carcinoma. FVPTC tumors were modestly, but significantly, smaller than papillary carcinoma tumors (1.2 versus 1.6 cm). Metastases to cervical lymph nodes occurred least often in patients with FVPTC and usually were detected within 3 months of diagnosis. The frequency of distant metastases within this limited period of follow-up did not differ between FVPTC and papillary carcinoma.
Fine-needle aspiration appears to be superior to frozen section for identification of FVPTC, although the number of aspirations performed was limited. Greater use of aspiration may permit more appropriate surgical management of this disease. Local and distant metastases of FVPTC do not occur more often than do those of papillary carcinoma.
进行了一项回顾性临床病理研究，以确定诊断和治疗程序对甲状腺乳头状癌滤泡变体（FVPTC）患者预后的影响。
将37例FVPTC患者的结果与37例随机选择的乳头状癌患者和22例滤泡癌患者的结果进行比较。通过回顾临床和组织学资料获得诊断、治疗和随访数据。
所有组的中位随访时间约为3年。细针穿刺对FVPTC的敏感性为75%，与乳头状癌相似。冰冻切片评估对FVPTC的敏感性仅为27%，但对乳头状癌为94%，对滤泡癌为44%。所有细针穿刺标本具有乳头状癌细胞学特征且冰冻切片提示为滤泡性病变的患者均被证实患有FVPTC：因此，FVPTC患者行半甲状腺切除术的频率是乳头状癌患者的三倍。FVPTC肿瘤略小于乳头状癌肿瘤，但差异有统计学意义（1.2对1.6 cm）。FVPTC患者发生颈部淋巴结转移的情况最少，通常在诊断后3个月内被检测到。在这一有限的随访期内，FVPTC和乳头状癌远处转移的频率没有差异。
尽管细针穿刺的次数有限，但对于FVPTC的识别，细针穿刺似乎优于冰冻切片。更多地使用穿刺可能允许对该疾病进行更合适的手术管理。FVPTC的局部和远处转移并不比乳头状癌更常见。
