恶性肿瘤家族史与散发性甲状腺乳头状癌临床病理特点的关系研究

Study on the relationship between family history of malignant tumor and clinicopathological characteristics of sporadic papillary thyroid carcinoma

目的探究恶性肿瘤家族史(family history of malignant tumor,FHOMT)与散发性甲状腺乳头状癌(papillary thyroid cancer,PTC)患者临床病理特征的关系,为个体化诊疗提供依据。方法收集2017-01-01至2019-09-30期间于武汉大学人民医院乳腺甲状腺外科行首次甲状腺手术,且病理诊断为PTC的患者。根据FHOMT的有无、肿瘤类型及亲属类型分组比较其临床病理特征。结果在2123例患者中,无FHOMT患者1932例,有FHOMT患者191例。最常见的FHOMT是肺癌家族史(1.80%)。与无FHOMT的PTC患者相比,有FHOMT的PTC患者发病年龄更晚(P=0.000),中央组淋巴结转移比例更低(P=0.004),侵犯包膜的比例更小(P=0.021)。呼吸相关FHOMT的PTC患者发病年龄更晚(P=0.000)。一级亲属为男性PTC患者的发病年龄更晚(P=0.000),一级亲属为女性PTC患者发生中央组淋巴结转移的比例更低(P=0.007)。结论有FHOMT的PTC患者与无FHOMT的PTC患者相比,在发病年龄、中央组淋巴结转移以及侵犯包膜上存有差异。

Objective To investigate the relationship between family history of malignant tumor(FHOMT) and clinicopathological features of patients with sporadic papillary thyroid carcinoma(PTC), and to provide basis for individualized diagnosis and treatment. Methods Patients admitted to the department of breast and thyroid surgery in Renmin Hospital of Wuhan University from January 1, 2017 to September 30, 2019 for thyroid surgery for the first time and pathologically diagnosed as PTC were collected. According to the presence or absence of FHOMT, tumor type and family member type, their clinicopathological features were compared. Results In 2 123 patients, there were 1 932 patients without FHOMT and 191 patients with FHOMT. The most common FHOMT was the family history of lung cancer(1.80%). Compared with PTC patients without FHOMT, PTC patients with FHOMT had a later onset age(P=0.000), a lower proportion of central lymph node metastasis(P=0.004), and a lower ratio of capsule invasion(P=0.021).PTC patients with respiratory-related FHOMT had a later onset age(P=0.000). PTC patients with male first-degree relatives had a later onset age(P=0.000). And PTC patients whose first-degree relatives were female had a lower proportion of central lymph node metastasis(P=0.007). Conclusion There are differences in onset age, central lymph node metastasis and capsule invasion between PTC patients with and without FHOMT.