摘要
目的探讨甲状腺未分化癌的临床病理特点及预后情况。方法收集甲状腺未分化癌的临床病理资料并随访,最近的随访截止日期为2023-04-16。结果女性32例(61.5%),男性20例(38.5%)。患者平均年龄62.7岁。肿瘤梭形细胞成分为主,有40.4%病例混合甲状腺乳头状癌/滤泡癌/鳞状细胞癌(21/52)。免疫组化方面,Vimentin表达率为95.2%,SMA局部阳性率为37.5%,p53阳性率(64.3%),TTF-1、TG及PAX-8少数阳性,上皮标记多阳性,Ki-67中位增殖指数50%。对照无滤泡癌的未分化癌组,伴有滤泡癌的未分化癌最大径较大(r=0.599,P=0.005),总生存时间/癌症特异性生存时间缩短[(4.29±1.21)个月vs.(55.06±17.68)个月,P=0.028]。与未合并PTC的未分化癌组比较,局部合并有PTC成分的9例未分化癌组,总生存时间长[(85.95±38.20)个月vs.(16.54±5.26)个月,P=0.057],复发癌的发生在该组比例要高(33.3%vs.4.7%,P=0.031)。吸烟史的患者总生存时间/癌症特异性生存时间缩短。本组未分化癌的总生存率:半年生存率(45.0±9.0)%,1年生存率(33.0±8.0)%,2年生存率(23.0±8.0)%,5年及10年生存率均为(19.0±7.0)%。结论甲状腺未分化癌预后差,伴有滤泡癌的未分化癌更差,伴有乳头状癌的未分化癌预后较好。甲状腺未分化癌可能更多来源于滤泡癌。
Objective To explore the clinicopathologic characteristics and prognosis states of undifferentiated thyroid carcinomas(UTC).Methods Clinicopathologic data of poorly differentiated carcinomas were collected and patients with UTC were visited.The final follow-up deadline was April 16,2023.Results There were 32 female patients(61.5%)and 20 male patients(38.5%),and their average age was 62.7 years.Spindle-shaped cell tumor was dominant,and 40.4%of patients were accompanied by papillary thyroid carcinoma(PTC),follicular carcinoma and squamous-cell carcinoma(21/52).In terms of immunohistochemistry(IHC),vimentin had an expression rate at 95.2%;37.5%of SMA was partially positive;p53+(64.3%);TTF-1,TG and PAX-8 were positive at a low rate and epithelial markers were mostly positive,and the mean Ki67 proliferation index was 50%.Compared with the UTC group without follicular carcinoma,the maximum diameter of the UTC with follicular carcinoma was larger(r=0.599,P=0.005),and its overall survival/cancer-specific survival(OS/CSS)was shorter(4.29±1.21 m vs.55.06±17.68 m,P=0.028).After comparing with the UTC group with unmerged PTC,the probability of recurrency in a partial scope of 9 patients with PTC components in the UTC group was higher(33.3%vs.4.7%,P=0.031),and the total survival time was longer(85.95±38.20 m vs.16.54±5.26 m,P=0.057).Patients with a history of smoking had a shorter overall survival time.The overall survival rates of the UTC group were that the semi-annual survival rate was in the range of 45.0±9.0%,the one-year survival rate was in the range of 33.0±8.0%,the two-year survival rate was in the range of 23.0±8.0%,and the fiveyear and ten-year survival rates were in the range of 19.0±7.0%.Conclusion The UTC prognosis state is poor,that with follicular carcinoma is worse,and that with PTC might be better.More commonly,UTC might be derived from follicular carcinoma.
作者
王红群
李杰
刘鹏
李金龙
石怀银
WANG Hong-qun;LI Jie;LIU Peng;LI Jin-long;SHI Huai-yin(Graduate School,Medical College of Chinese People’s Liberation Army,Beijing 100853,China;Department of Pathology,the First Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100853,China)
出处
《诊断病理学杂志》
2023年第9期867-871,共5页
Chinese Journal of Diagnostic Pathology
关键词
甲状腺未分化癌/间变性癌
临床病理特点
预后
Undifferentiated thyroid carcinomas/anaplastic thyroid carcinoma
Clinicopathologic characteristics
Prognosis
