Evans H L, Vassilopoulou-Sellin R
Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Am J Surg Pathol. 1998 Dec;22(12):1512-20. doi: 10.1097/00000478-199812000-00008.
University of Texas M. D. Anderson Cancer Center cases filed as Hurthle cell and follicular carcinoma were reviewed. Requirements for including a case in the study were that the diagnosis of Hurthle cell or follicular carcinoma be confirmed, that histologic material and clinical information be adequate, and that there be at least 9 years of follow-up. The study group included 18 cases of Hurthle cell carcinoma and 33 cases of follicular carcinoma. Ten of the Hurthle cell carcinomas had extrathyroid invasion, three had intrathyroid invasion, and five were encapsulated (i.e., they had intracapsular invasion only). In the follicular carcinoma group, 5 tumors had extrathyroid invasion, 14 had intrathyroid invasion, and 14 were encapsulated. When the cases were stratified according to extent of invasion in this manner, there was no statistically significant difference in rate of local recurrence, rate of metastasis (either regional lymph node or distant), or patient survival between Hurthle cell carcinoma and follicular carcinoma. Other variables including patient age and sex, treatment differences, tumor size, vascular invasion, predominant growth pattern (follicular versus solid-trabecular), nuclear size and pleomorphism, mitotic rate, and tumor necrosis did not provide significant additional prognostic information. Metastases of both Hurthle cell and follicular carcinoma were mostly distant and predominantly involved bone and lung. Behavioral differences between Hurthle cell and follicular carcinoma that were not statistically significant included a higher rate of local recurrence in Hurthle cell carcinoma with intrathyroid invasion, more frequent occurrence of regional lymph node metastasis in Hurthle cell carcinoma with extrathyroid invasion, and absence of distant metastasis and death caused by tumor in encapsulated Hurthle cell carcinoma. Five follicular carcinomas and one Hurthle cell carcinoma appeared to have arisen within an adenoma.
对德克萨斯大学MD安德森癌症中心登记为嗜酸性细胞癌和滤泡状癌的病例进行了回顾。纳入本研究的病例要求如下：嗜酸性细胞癌或滤泡状癌的诊断得到确认，组织学材料和临床信息充足，并且至少有9年的随访时间。研究组包括18例嗜酸性细胞癌和33例滤泡状癌。10例嗜酸性细胞癌有甲状腺外侵犯，3例有甲状腺内侵犯，5例有包膜（即仅包膜内侵犯）。在滤泡状癌组中，5例肿瘤有甲状腺外侵犯，14例有甲状腺内侵犯，14例有包膜。当按这种侵犯程度对病例进行分层时，嗜酸性细胞癌和滤泡状癌在局部复发率、转移率（区域淋巴结转移或远处转移）或患者生存率方面没有统计学上的显著差异。其他变量，包括患者年龄和性别、治疗差异、肿瘤大小、血管侵犯、主要生长模式（滤泡状与实体小梁状）、核大小和多形性、有丝分裂率以及肿瘤坏死，均未提供显著的额外预后信息。嗜酸性细胞癌和滤泡状癌的转移大多为远处转移，主要累及骨骼和肺部。嗜酸性细胞癌和滤泡状癌之间在行为上的差异无统计学意义，包括甲状腺内侵犯的嗜酸性细胞癌局部复发率较高、甲状腺外侵犯的嗜酸性细胞癌区域淋巴结转移更常见，以及包膜内嗜酸性细胞癌无远处转移和肿瘤致死情况。5例滤泡状癌和1例嗜酸性细胞癌似乎起源于腺瘤内。
