家族性与散发性甲状腺乳头状癌的临床病理特征分析  

Clinicopathologic characteristics of familial versus sporadic papillary thyroid carcinoma

作　　者：梁冀望[1] 李振东[1] 李树春[1] 黄波[2] 刘宏伟[1] 李延国[1] 

机构地区：[1]辽宁省肿瘤医院头颈外科,沈阳110042 [2]辽宁省肿瘤医院病理科,沈阳110042

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第6期502-506,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的分析探讨家族性甲状腺乳头状癌（familial papillary thyroid carcinoma，FPTC）与散发性甲状腺乳头状癌（sporadic papillary thyroid carcinoma，SPTC）的临床病理特征。方法回顾性分析2008年1月至2014年8月辽宁省肿瘤医院诊治的7个家系20例FPTC患者的临床病理资料，按比例随机抽取同期治疗的85例SPTC患者临床病理资料作为对照组。采用t检验和x。检验进行统计学分析。结果纳入的FPTC患者占同期收治甲状腺癌总例数的1．3％（20／1587），其中男8例，女12例，中位发病年龄37岁，14例FPTE为同胞关系，6例为亲子关系。与SPTC组相比，FPTC组患者易伴发桥本病（P〈0．01）和结节性甲状腺肿（P=0．04），两组在双侧发病（P〈0．01）、多癌灶（P〈0．叭）、病理亚型（P〈0．01）、中央区淋巴结转移（P=0．02）方面差异均有统计学意义。具有同胞关系和亲子关系的FPTC患者术前促甲状腺激素水平（P=0．02）、伴发桥本病方面的差异有统计学意义（P=0．01）。结论FFFC可能具有更高的侵袭性，具有同胞关系和亲子关系的FPTC患者也存在不同的临床特征。对于有家族聚集性倾向的家系应早筛查，建议一级亲属长期随诊，对患者采取积极的治疗策略以争取较好的治疗效果。Objective To investigated the clinicopathologic features of familial papillary thyroid carcinoma （PTC） compared to sporadic PTC. Methods Between January 2008 and August 2014, 20 patients who underwent surgely at Liaoning Cancer Hospital and Institute were diagnosed with familial PTC. We compared the clinicopathologic characteristics between familial PTC and sporadic PTC. Results The prevalence of familial PTC was 1. 3% （20/1 587 ）. The median age of patients at diagnosis was 37 years and there were 12 females and 8 males. Thirty percent of the familial PTC cases exhibited a parent- offspring relationship, and 70% exhibited a sibling relationship. There were significant differences between familial PTC and sporadic PTC in terms of concomitant chronic thyroiditis （P 〈 0.01 ） , nodular goiter（ P = 0.04 ）, tumor multicentricity （ P 〈 0.01 ） , bilaterality （ P 〈 0.01 ）, histological subtype （ P 〈 0.01 ）, and central lymph node metastasis （ P = 0.02 ）. When familial PTC patients were classified based on parent-child and sibling relationship, there were significant differences in preoperative TSH level （P = 0. 02 ） and concomitant chronic thyroiditis （P = 0.01 ） between the two categories. Conclusions There are significant differences in clinicopathologie features between familial PTC and sporadic PTC and between familial PTC with parent-child and those with sibling relationship. Familial PTC appears more aggressive than sporadic carcinoma. Optimal treatment for familial PTC is not yet established, but improved awareness and screening will permit earlier detection, more timely intervention, and improved outcomes for patients and their families.

关 键 词：甲状腺肿瘤 癌 乳头状 病理学 临床 

分 类 号：R736.1[医药卫生—肿瘤]