Background： The first and most important step in characterizing familial nonmedullary thyroid carcinoma （NMTC） is to distinguish the true familial patients, which is the prerequisite for all accurate analyses. This...Background： The first and most important step in characterizing familial nonmedullary thyroid carcinoma （NMTC） is to distinguish the true familial patients, which is the prerequisite for all accurate analyses. This study aimed to investigate whether patients from families with ≥3 first-degree relatives affected with NMTC have different characteristics than patients from families with only two affected members, and to compare these patients with those with sporadic disease. Methods： We analyzed the clinicopathological features and prognosis of 209 familial and 1120 sporadic cases of NMTC. Familial patients were further divided into two subgroups： families with two affected members and families with ≥3 affected members. Results： The familial group had a significantly higher risk of bilateral growth, multifocality, extrathyroidal extension, and lateral lymph node metastasis than the sporadic group （P 〈 0.05）. These main features were also different between the group with ≥3 affected members and the sporadic group. The only difference between the two affected members＇ group and the sporadic group was incidence of multifocality （P 〈 0.05）. The probability of disease recurrence in patients from families with ≥3 affected members was significantly higher than that in sporadic cases （14.46% vs. 5.27%; P = 0.001）, while the probability in patients from families with two affected members was similar to that in sporadic patients （6.35% vs. 5.27%; P = 0.610）. The Kaplan–Meier survival analysis showed a statistically significant difference in disease-free survival between the two subgroups （85.54% vs. 93.65%; P = 0.045）. Conclusions： Patients from families with ≥3 members affected by NMTC have more aggressive features and a worse prognosis than those from families with only two affected members. Patients from families with ≥3 affected first-degree relatives may be considered to have true familial NMTC.展开更多
Background： Familial nonmedullary thyroid carcinoma （FNMTC） is a variant of nonmedullary thyroid carcinoma（NMTC） with particular clinicopathologic features. In recent years, a number of studies have shown that FN...Background： Familial nonmedullary thyroid carcinoma （FNMTC） is a variant of nonmedullary thyroid carcinoma（NMTC） with particular clinicopathologic features. In recent years, a number of studies have shown that FNMTC is more invasive than sporadic NMTC（SNMTC）. The purpose of this study was to explore the differences in clinicopathologic features of FNMTC between different types of families and to determine in which of these families more invasive FNMTC occurred. Methods： We retrospectively reviewed all patients with thyroid carcinoma admitted to Peking Union Medical College Hospital from January 2009 to July 2013 in the database. Of all 2000 cases, 55 met the inclusive criteria for FNMTC and were studied. There are two different grouping methods. The first is that all samples were allocated to families with three or more first-degree relatives affected （FNMTC-3 group） and families with only two affected first-degree relatives （FNMTC-2 group）. The second is that all patients were divided into families with three or more affected first-degree relatives over two generations （FNMTC-3-2 group） and the other families. We compared the clinicopathologic features such as sex, age, tumor size, multifocality, location, complications by thyroiditis, complications by benign thyroid nodules, surgical procedure, capsule invasion, histological type, lymph node metastases, tumor node metastasis stage, and BRAF mutation between FNMTC-2 group and FNMTC-3 group. We also made the same comparison between FNMTC-3-2 group and other families. Results： No pronounced differences in clinicopathological features were present between FNMTC-2 group and FNMTC-3 group. The proportion of FNMTC-3-2 group aged 〈45 years was significantly higher than that in the other families （58.8% vs. 26.3%, P = 0.021）. A similar difference was found in the proportion of lymph node metastasis （64.7% vs. 34.2%, P = 0.035）. Conclusions： FNMTC-3-2 is more invasive than the other families. Early screening and positive treatment for members of these families are recommended.展开更多
文摘Background： The first and most important step in characterizing familial nonmedullary thyroid carcinoma （NMTC） is to distinguish the true familial patients, which is the prerequisite for all accurate analyses. This study aimed to investigate whether patients from families with ≥3 first-degree relatives affected with NMTC have different characteristics than patients from families with only two affected members, and to compare these patients with those with sporadic disease. Methods： We analyzed the clinicopathological features and prognosis of 209 familial and 1120 sporadic cases of NMTC. Familial patients were further divided into two subgroups： families with two affected members and families with ≥3 affected members. Results： The familial group had a significantly higher risk of bilateral growth, multifocality, extrathyroidal extension, and lateral lymph node metastasis than the sporadic group （P 〈 0.05）. These main features were also different between the group with ≥3 affected members and the sporadic group. The only difference between the two affected members＇ group and the sporadic group was incidence of multifocality （P 〈 0.05）. The probability of disease recurrence in patients from families with ≥3 affected members was significantly higher than that in sporadic cases （14.46% vs. 5.27%; P = 0.001）, while the probability in patients from families with two affected members was similar to that in sporadic patients （6.35% vs. 5.27%; P = 0.610）. The Kaplan–Meier survival analysis showed a statistically significant difference in disease-free survival between the two subgroups （85.54% vs. 93.65%; P = 0.045）. Conclusions： Patients from families with ≥3 members affected by NMTC have more aggressive features and a worse prognosis than those from families with only two affected members. Patients from families with ≥3 affected first-degree relatives may be considered to have true familial NMTC.
文摘Background： Familial nonmedullary thyroid carcinoma （FNMTC） is a variant of nonmedullary thyroid carcinoma（NMTC） with particular clinicopathologic features. In recent years, a number of studies have shown that FNMTC is more invasive than sporadic NMTC（SNMTC）. The purpose of this study was to explore the differences in clinicopathologic features of FNMTC between different types of families and to determine in which of these families more invasive FNMTC occurred. Methods： We retrospectively reviewed all patients with thyroid carcinoma admitted to Peking Union Medical College Hospital from January 2009 to July 2013 in the database. Of all 2000 cases, 55 met the inclusive criteria for FNMTC and were studied. There are two different grouping methods. The first is that all samples were allocated to families with three or more first-degree relatives affected （FNMTC-3 group） and families with only two affected first-degree relatives （FNMTC-2 group）. The second is that all patients were divided into families with three or more affected first-degree relatives over two generations （FNMTC-3-2 group） and the other families. We compared the clinicopathologic features such as sex, age, tumor size, multifocality, location, complications by thyroiditis, complications by benign thyroid nodules, surgical procedure, capsule invasion, histological type, lymph node metastases, tumor node metastasis stage, and BRAF mutation between FNMTC-2 group and FNMTC-3 group. We also made the same comparison between FNMTC-3-2 group and other families. Results： No pronounced differences in clinicopathological features were present between FNMTC-2 group and FNMTC-3 group. The proportion of FNMTC-3-2 group aged 〈45 years was significantly higher than that in the other families （58.8% vs. 26.3%, P = 0.021）. A similar difference was found in the proportion of lymph node metastasis （64.7% vs. 34.2%, P = 0.035）. Conclusions： FNMTC-3-2 is more invasive than the other families. Early screening and positive treatment for members of these families are recommended.
