贵阳市某三甲医院具有乳头样核特征的非浸润性甲状腺滤泡性肿瘤的患病情况分析  

Prevalence analysis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in a Third Class A Level Hospital in Guiyang

作　　者：郭永慧 彭年春 时立新 张巧 胡颖 项一宁 杨文秀 Guo Yonghui;Peng Nianchun;Shi Lixin;Zhang Qiao;Hu Ying;Xiang Yining;Yang Wenxiu(Department of Endocrinology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学附属医院内分泌科,贵阳550004 [2]贵州医科大学附属医院病理科,贵阳550004

出　　处：《中华内分泌代谢杂志》2018年第11期915-919,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：2016年贵州省临床重点专科培育项目(SZD-2016-01).

摘　　要：目的了解运用2017年内分泌器官肿瘤世界卫生组织(WHO)分类标准重新诊断的包膜型滤泡亚型甲状腺乳头状癌(encapsulated follicular variant of papillary thyroid carcinoma,EFVPTC)及具有乳头样核特征的非浸润性甲状腺滤泡性肿瘤(noninvasive follicular thyroid neoplasm with papillary-like nuclear features,NIFTP)在贵阳市的流行情况。方法回顾性分析2009至2016年于贵州医科大学附属医院行甲状腺手术并经病理确诊为甲状腺癌患者的病历资料。依据2004年WHO内分泌器官肿瘤病理学和遗传学标准诊断甲状腺乳头状癌、滤泡亚型乳头状癌(follicular variant of papillary thyroid carcinoma,FVPTC),依据2017年内分泌器官肿瘤WHO分类标准对其中的甲状腺乳头状癌进行重新阅片,确诊EFVPTC及NIFTP,分析NIFTP的患病情况及预后。结果1207例甲状腺癌中,乳头状癌为1150例,占甲状腺癌的构成比为95.28%;FVPTC为72例,占甲状腺癌构成比为5.97%;2009至2016年FVPTC占甲状腺癌的构成比呈总体下降趋势(P<0.05)。经再次阅片后诊断无包膜侵袭性FVPTC为10例,占甲状腺癌构成比0.83%;EFVPTC为62例,占甲状腺癌构成比5.14%,包括经2017年内分泌器官肿瘤WHO分类标准证实为NIFTP的2例和发生包膜浸润的60例,占甲状腺癌的构成比分别为0.17%和4.97%。62例EFVPTC,除外失访的11例,对其余51例EFVPTC进行随访。将死亡、局部转移或远处转移、复发定义为不良事件。随访的49例浸润性EFVPTC中11例发生不良事件(包括2例死亡病例);NIFTP 2例存活且无明显疾病证据。结论2017年WHO内分泌器官肿瘤新分类标准中关于NIFTP的诊断对贵阳市的预期影响较小。Objective To analyze of the prevalence of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC)and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) by 2017 World Health Organization (WHO) classification of tumors of endocrine organs in Guiyang.Methods A retrospectively analysis of patients who had a thyroid surgery and confirmed thyroid cancer by pathological diagnosis in the Affiliated Hospital of Guizhou Medical University from 2009 to 2016.PTC and FVPTC by 2014 WHO classification of tumors of endocrine organs,and according to the 2017 WHO classification of tumors of endocrine organs ,the thyroid papillary carcinomas were reviewed and some had been confirmed as EFVPTC and NIFTP,with analysis of the prevalence and prognosis of NIFTP.Results Of the 1207 cases of thyroid carcinoma,1150 cases were papillary carcinoma,the constituent ratio of thyroid carcinoma was 95.28%,the FVPTC was 72 cases,and the proportion of thyroid carcinoma was 5.97%;the proportion of FVPTC in thyroid carcinoma decreased from 2009 to 2016(P<0.05).After pathological sections being reviewed,10 cases had been confirmed as non-encapsulated infiltrative FVPTC,the ratio of thyroid cancer to thyroid cancer was 0.83%;EFVPTC was found in 62 cases,accounting for 5.14% of thyroid carcinoma,these included 2 cases of NIFTP confirmed by the 2017 WHO classification of tumors of endocrine organs and 60 cases encapsulated invasive FVPTC,the percentage of thyroid carcinoma was 0.17% and 4.97%.62 cases of EFVPTC with the exception of 11 cases without further visit,while the remaining 51 cases of EFVPTC were followed up.Death,local or distant metastases were defined as adverse events.An adverse event was seen in 11 of 49 of the cases of invasive EFVPTC,including 2 died of disease;The NIFTP were alive with no evidence of disease.Conclusion The diagnosis of NIFTP according to new WHO classification of endocrine organ tumors in 2017 has little expected impact in Guiyang.

关 键 词：滤泡型甲状腺乳头状癌 包膜型甲状腺滤泡型乳头状癌 具有乳头样核特征的非浸润性甲状腺滤泡性肿瘤 流行病学研究 

分 类 号：R736.1[医药卫生—肿瘤]