第五版WHO甲状腺肿瘤分类中低风险肿瘤的解读

Interpretation of low-risk neoplasms in the 5th edition of WHO classification of thyroid tumors

第五版世界卫生组织(WHO)甲状腺肿瘤分类以“低风险肿瘤”取代第四版中的“交界性肿瘤”,包括具有乳头状核特点的非浸润性甲状腺滤泡性肿瘤、恶性潜能未定的肿瘤和透明变梁状肿瘤,均为滤泡上皮细胞起源、有包膜/界限清楚、无淋巴结和远处转移的甲状腺肿瘤(EX0、N0、M0)。WHO强调,“低风险肿瘤”扩散概率极低,该命名可保护病理医师遇到罕见特殊转移病例而免于医疗诉讼。本文在解读该肿瘤分类的基础上,进一步探讨几种其他WHO未包括的低风险肿瘤。

The fifth edition of World Health Organization(WHO)classification of thyroid tumors replaced the"borderline tumors"in the fourth edition with"low-risk tumors",including noninvasive follicular thyroid neoplasms with papillary-like nuclear features,uncertain malignant potential and hyalinizing trabecular tumors.All of them are thyroid tumors with follicular epithelial cell origin,capsule/clear boundary,no lymph node and distant metastasis(EX0,N0,M0).The spread probability of"low-risk tumor"is extremely low,and this new classification can protect the pathologists from medical litigation when encountering rare and special metastatic cases.Based on the interpretation of the thyroid tumor classification,this paper further discussed several low-risk tumors,which were not listed in the current WHO classification.