甲状腺乳头状癌滤泡亚型临床病理特征分析

The clinicopathological features of follicular variant of papillary thyroid carcinoma

目的分析甲状腺乳头状癌滤泡亚型的临床病理特征。方法回顾性分析2006年1月至2012年6月间131例甲状腺乳头状癌滤泡亚型患者的临床资料。结果甲状腺乳头状癌滤泡亚型患者确诊年龄范围为13～76岁，中位年龄为45岁，女97例，占74．0％，其中包膜亚型组38例，占29％，非包膜亚型组93例，占71％。与经典型甲状腺乳头状癌相比，滤泡亚型患者在超声诊断准确率、冰冻诊断准确率、病灶多中心性、病灶双侧性、淋巴结转移、侧颈淋巴结转移、N分期、M分期、TNM分期、ATA风险和伴发桥本甲状腺炎上差异均有统计学意义（均P〈0．05）。而滤泡亚型的非包膜组与包膜组之间在肿瘤直径、TSH水平、超声诊断准确率、侵出腺叶、T分期、淋巴结转移、N分期、TNM分期、ATA风险分组及复发上差异均有统计学意义（均P〈0．05）。结论甲状腺乳头状癌滤泡亚型具有与经典型不同的临床病理特征，对于FVPTC的不同亚组应采取对应的治疗方式。

Objective To analyze the clinical and pathological features of follicular variant of papillary thyroid carcinoma （FVPTC）. Methods Clinical data of 131 FVPTC patients diagnosed and treated between January 2006 and June 2012 were retrospectively analyzed. Results Of the 131 FVPTC patients, the median age at diagnosis was 45 years and 74. 0% patients were female. Pathologically 29% （38 patients） of the FVPTC patients were encapsulated, and 71% （93 patients） were nonencapsulated. Compared with classical papillary thyroid carcinoma （ CPTC）, FVPTC patients were more likely to have lower ultrasound diagnostic accuracy rate, frozen section accuracy rate, tumor muhicentricity, tumor bilaterality, lymph node metastasis, lateral lymph node metastasis rate, N staging, TNM stage, ATA risk and higher M staging and concomitant chronic thyroiditis rate （ all P 〈 0.05 ）. Moreover, there were significant differences between nonencapsulated and encapsulated follicular variant of papillary thyroid carcinoma in tumor size, TSH level, ultrasound diagnostic accuracy rate, extrathyroid invasion, T staging, lymph node metastasis, N staging, TNM staging, ATA risk and recurrence rate （ all P 〈 0. 05 ）. Conclusions Compared with CPTC, FVPTC have different clinical and biological features. It＇s necessary for different management strategies for different FVPTC patients.