弥漫钙化型甲状腺癌的临床生物学特性研究

Clinical biological characteristics of diffuse calcified variant of papillary thyroid carcinoma

目的探讨弥漫钙化型甲状腺癌的临床生物学特性及处理原则。方法回顾性分析天津医科大学肿瘤医院头颈外科2011年1月至2015年12月收治的21例具有完整病例资料的甲状腺弥漫钙化患者,同时收集105例同期甲状腺非弥漫钙化结节、术后病理证实为甲状腺乳头状癌患者,统计患者的性别、年龄、超声特征、甲状腺功能、病理类型、淋巴结转移、BRAF V600E突变及随访等,分析不同病例的临床生物学特性。结果两组患者在性别、年龄、是否合并桥本甲状腺炎之间差异均无统计学意义(均P>0.05);而在双侧患病率、中央区淋巴结转移、侧颈淋巴结转移、术后标本BRAF V600E突变蛋白表达阳性率差异均有统计学意义(均P<0.01)。术后随访分析显示两组颈部淋巴结复发率差异无统计学意义(P>0.05)。结论弥漫钙化型甲状腺癌是一种新的甲状腺乳头状癌亚型,具有独特的临床生物学特性,对其应采取更加积极的临床处理方案。

Objective To investigate clinicobiological characteristics and treatment principles of diffuse calcified variant of papillary thyroid carcinoma.Methods Twenty one patients with diffuse calcified thyroid glands admitted to the Department of Head and Neck Surgery of Tianjin Medical University Cancer Hospital from Jan 2011 to Dec 2015 were enrolled in the study group.One humdred and five patients with papillary thyroid carcinoma(PTC)confirmed by postoperative pathology(non-diffuse calcified thyroid nodules)during the corresponding period were included into the control group.The clinicobiological characteristics of different cases were analyzed by collecting the following information:gender,age,ultrasonic features,thyroid function,pathological type,lymph node metastasis,BRAF V600E mutation and follow-up.Results No significant difference was found between the study group and the control group in gender,age or the number of patients complicated with Hashimoto′s thyroiditis;while there were significant differences in bilateral involvement of central lymph node metastasis,lateral neck lymph node metastasis and positive rate of BRAF V600E mutant protein expression in postoperative specimens(P<0.01).As found by postoperative follow-up,there was no significant difference in the rate of neck lymph node recurrence between the two groups.Conclusions Diffuse calcified variant of papillary thyroid carcinoma is a new subtype of PTC with unique clinicobiological characteristics,and more active clinical treatment programme should be adopted for the diffuse calcified thyroid carcinoma.