鞋钉亚型甲状腺乳头状癌临床病理特征分析(附25例)  

Clinical and pathological characteristics analysis of Hobnail variant of papillary thyroid carcinoma(25 cases)

作　　者：谭志会 贾浩 唐雪峰 TAN Zhihui;JIA Hao;TANG Xuefeng(Department of Pathology,Chongqing People's Hospital,Chongqing 400000,China)

机构地区：[1]重庆市人民医院病理科,重庆400000

出　　处：《现代肿瘤医学》2025年第4期648-652,共5页Journal of Modern Oncology

摘　　要：目的:通过探讨鞋钉亚型甲状腺乳头状癌(Hobnail variant of papillary thyroid carcinoma,HV-PTC)的临床病理学特征,为临床手术方案的制定及精确治疗提供依据,降低第二次手术率及远期病死率。方法:回顾性分析2021年至2022年我院病理科存档的甲状腺乳头状癌(papillary thyroid carcinoma,PTC)病例2945例,均行单侧甲状腺腺叶切除术及患侧中央区淋巴结清除术,依据术后病理结果分为HV-PTC组、经典型PTC(classical of papillary thyroid carcinoma,c-PTC)组和合并鞋钉成份比例<30%的c-PTC(c-PTC+HV)组,对比三组数据,分析HV-PTC的临床病理学特征。结果:2945例PTC中HV-PTC组25例,c-PTC+HV组146例,c-PTC组2774例。HV-PTC组和c-PTC+HV组与c-PTC组的对照研究,病人确诊年龄、病灶数目均无显著性变化(P>0.05);HV-PTC组和c-PTC+HV组肿瘤直径均大于c-PTC组(P=0.0002,P<0.0001),并且患侧中央区淋巴结转移率均高于c-PTC组(P=0.0099,P<0.0001);c-PTC+HV组淋巴结中癌转移灶大小大于c-PTC组(P<0.0001)。结论:HV-PTC与c-PTC相比,通常原发癌灶的直径更大,患侧中央区淋巴结转移率更高,并且转移癌灶的直径更大,更具有侵袭性。Objective:To investigate the clinical pathology characteristics of Hobnail variant of papillary thyroid carcinoma(HV-PTC),and to provide the basis for clinical operation and precise treatment,and to reduce the second operation rate and long-term mortality.Methods:Retrospective analysis of 2945 cases of papillary thyroid carcinoma(PTC)2021 in the department of pathology of our hospital in 2022.All cases underwent unilateral lobectomy of thyroid gland and lymph node dissection of the affected side in central district,according to the postoperative pathological results,the patients were divided into three groups:HV-PTC group,classical of papillary thyroid carcinoma(c-PTC)group and c-PTC+HV group,analyze the clinical pathology signature of the HV-PTC.Results:There were 25 cases in the HV-PTC group,146 cases in the c-PTC+HV group,and 2774 cases in the c-PTC group among 2945 PTC cases.A comparative study between the HV-PTC group and the c-PTC+HV group and the c-PTC group showed no significant changes in the age of diagnosis and the number of lesions(P>0.05).The tumor diameter in the HV-PTC group and c-PTC+HV group was larger than that in the c-PTC group(P=0.0002,P<0.0001),and the incidence of lymph node metastasis in the central region of the affected side was higher than that in the c-PTC group(P=0.0099,P<0.0001).The size of cancer metastasis in the lymph nodes of the c-PTC+HV group was larger than that of the c-PTC group(P<0.0001).Conclusion:HV-PTC typically has a larger diameter of the primary lesion,a higher rate of lymph node metastasis in the affected central district,and a larger,more aggressive metastatic lesion compared with c-PTC.

关 键 词：甲状腺乳头状癌 鞋钉亚型 患侧中央区淋巴结 转移癌灶直径 

分 类 号：R736.1[医药卫生—肿瘤]