Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group
Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group
复制标题
DOI：
10.1136/jcp.2004.017889
复制
发表时间：
2004-10-01
影响因子：
3.4
通讯作者：
Miyauchi, A
中科院分区：
文献类型：
--
作者：
Kakudo, K;Tang, W;Miyauchi, A
目的：甲状腺乳头状癌（PTC）分为普通型和其他组织学类型。进一步亚组的常见类型和患者预后之间的相关性没有很好的documented.Aims：介绍两种新的组织学参数，以cretinPTC细胞极性和细胞凝聚力的损失损失。目的：探讨一种新的具有预后价值的普通型PTC亚群。检查这些PTC的组织学特征，包括肿瘤生长模式、包裹、甲状腺外浸润、细胞极性丧失和细胞凝聚力丧失，并与无病生存期（DFS）相关。多变量分析显示，除了性别（男性）和肿瘤大小（>4 cm）外，未包裹PTC的浸润性生长是DFS较差的重要独立参数，而细胞极性和凝聚力的丧失、高龄（>60岁）、甲状腺外浸润和手术完整性仅在单变量分析中有意义。显示扩张性生长并保留细胞极性的PTC具有有利的过程，没有复发，也没有癌症相关的死亡。相比之下，PTC表现出细胞极性和/或侵入性生长的损失，没有肿瘤包膜有较高的复发风险。结论：细胞学特征本身不能预测患者的PTC的结果。这项研究首次表明，细胞极性的丧失和肿瘤生长模式是识别常见型PTC中所谓的低风险组和预测肿瘤复发和癌症相关死亡方面的患者结局的有用参数。
Aims: Papillary thyroid carcinoma (PTC) is classified into two subgroups-common type and other histological variants. Correlations between further subgrouping of the common type and patient prognosis are not well documented.Aims: To introduce two novel histological parameters to characterise PTC-loss of cellular polarity and loss of cellular cohesiveness. To investigate a new subgroup of common type PTC with possible prognostic value.Methods: In total, 213 patients with PTCs larger than 1 cm were studied. Histological characteristics of these PTCs, including tumour growth pattern, encapsulation, extrathyroidal invasion, loss of cellular polarity, and loss of cellular cohesiveness were examined and correlated with disease free survival (DFS).Results: Multivariate analysis revealed that invasive growth of unencapsulated PTC, in addition to sex (male) and tumour size (>4 cm) were significant and independent parameters for poor DFS, whereas loss of cellular polarity and cohesiveness, old age (>60 years), extrathyroid invasion, and completeness of surgery were significant only in univariate analysis. PTCs that showed expansive growth and retained cellular polarity had a favourable course, with no recurrence and no cancer related deaths. In contrast, PTCs exhibiting loss of cellular polarity and/or invasive growth with no tumour capsule had a higher risk of recurrence.Conclusion: Cytological features alone cannot predict patient outcome in PTC. This study indicates for the first time that loss of cellular polarity and the tumour growth pattern are useful parameters for identifying the so called low risk group in common type PTC and in predicting patient outcome in terms of tumour recurrence and cancer related death.