甲状腺微小髓样癌的临床病理及预后分析  

Clinicopathological features and prognosis of micromedullary thyroid carcinoma

作　　者：刘伟[1] 王晓江[2] 彭凤英 杨世娟 朱伟峰[1] 肖伟进 钟礼花[1] LIU Wei;WANG Xiao-jiang;PENG Feng-ying;YANG Shi-juan;ZHU Wei-feng;XIAO Wei-jin;ZHONG Li-hua(Department of Pathology,Fujian Medical University Cancer Hospital/Fujian Cancer Hospital,Fuzhou 350014,China;Department of Molecular Pathology Laboratory,Fujian Medical University Cancer Hospital/FujianCancerHospital,Fuzhou350014,China)

机构地区：[1]福建医科大学附属肿瘤医院,福建省肿瘤医院病理科,福州350014 [2]福建医科大学附属肿瘤医院,福建省肿瘤医院分子病理研究室,福州350014

出　　处：《诊断病理学杂志》2022年第10期927-931,共5页Chinese Journal of Diagnostic Pathology

基　　金：福建省卫生计生青年科研课题(2018-1-18)。

摘　　要：目的 探讨甲状腺微小髓样癌(micro-MTC)的临床病理特征及预后。方法 收集micro-MTC 24例,对其临床特点、病理学及预后因素进行分析。结果 患者年龄36~71岁,中位年龄47岁,男女比1∶1.7,均为单侧甲状腺孤立性病变,直径0.1~1 cm,中位直径0.6 cm。镜下肿瘤无纤维性包膜,浸润周围甲状腺组织,13%(3/24)可见卫星结节;细胞轻度异型,核分裂罕见,未见坏死及脉管侵犯。临床Ⅰ期占75%,Ⅲ期占25%,30%(6/20)见淋巴结转移,无其他器官侵犯及远处转移。随访时间5~150个月,中位随访时间72个月,均无复发、转移,生化治愈率100%。结论 micro-MTC多发生于成年人,表现为单侧甲状腺孤立性病变,女性较男性多见,罕见复发转移,预后极好。Objective To investigate the clinicopathological features and prognosis of micromedullary thyroid carcinoma(micro-MTC). Methods A total of 24 cases of micro-MTC were collected, which clinical features, pathology and prognostic factors were analyzed. Results The patients were aged from 36 to 71 years, with a median age of 47 years, and the male to female ratio was 1∶1.7. All cases were unilateral solitary thyroid lesions. The tumor diameter were 0.1 cm~1 cm, and the median size was 0.6 cm. Microscopically, the tumor had no fibrous capsule, infiltrating surrounding thyroid tissue, and satellite nodules were observed in 13%(3/24) cases. The tumor cells showed mild atypia and rare mitosis, without necrosis and vascular invasion. 75% of patients were in stage Ⅰ and 25% in stage Ⅲ. Lymph node metastasis was observed in 30% of all cases(6/20), and no other organs involvement and distant metastasis were observed. The follow-up ranged from 5 months to 150 months, with a median of 72 months. No recurrence or metastasis was found in all patients, and the biochemical cure rate was 100%. Conclusion Micro-MTC occurs mostly in adults, presenting as unilateral solitary thyroid lesions, which are more commonly found in women than men, with rare recurrence, metastasis and excellent prognosis.

关 键 词：甲状腺微小髓样癌 甲状腺髓样癌 降钙素 预后 

分 类 号：R736.1[医药卫生—肿瘤]