摘要
目的阐明甲状腺乳头状癌(papillary thyroid carcinoma,PTC)组织学变型的临床生物学特点。方法选取我院自1974至1994年间收治的具有完整病历记录和随访观察的PTC病例505例,按国际最新甲状腺肿瘤的组织学分类标准重新分型,总结并分析各组织学变型的临床生物学特性。结果所有变型中,弥漫硬化型发生率最高,达20．0％;弥漫滤泡型、柱状细胞型及大滤泡型发生率最低。高细胞型、弥漫滤泡型、柱状细胞型和弥漫硬化型颈部淋巴结转移率和侵出腺外发生率较高,预后差;乳头状微癌和大滤泡型颈部淋巴结转移率和侵出率则较低,预后好。按照颈淋巴结转移发生率的高低差异可将所有变型分为高转移变型组(高细胞型、弥漫滤泡型、柱状细胞型、弥漫硬化型)、中转移变型组(滤泡型、嗜酸性细胞型、实体状变型、间质高度增生呈结节状筋膜炎样型、透明细胞型、典型PTC)和低转移变型组(大滤泡型、乳头状微癌),颈淋巴结转移率分别为83．0％,55．5％及34．1％(P<0．05)。结论PTC各组织学变型的临床生物学特性存在一定差异。应细化外科处理原则,以使患者得到更加恰当的治疗。
Objective To identify the clinical biological characteristic difference in the histological variants of papillary thyroid carcinoma （PTC） . Methods In this study,505 cases of PTC with complete medical records and follow-up surveys were selected. Clinical biological characteristic of the histological variants was investigated. Results Diffuse sclerosing variant was most common in all variants （20%）. Column cell variant, diffuse follicular variant, and macrofollicular variant had the least incidences. Diffuse sclerosing variant, tall cell variant, column cell variant and diffuse follicular variant were more aggressive. The prognosis varied significantly among the variants. The variants could be divided into three groups in terms of the rate of cervical lymph node metastasis. High metastases were found in diffuse sclerosing variant, tall cell variant, column cell variant and diffuse follicular variant, while low metastases in macrofollicular variant and papillary microcarcinomas. Conclusions The clinical biocharacteristics vary significantly among the variants in patients of PTC. Individual treatment should be addressed to PTC patients of different variants.
出处
《中华普通外科杂志》
CSCD
北大核心
2006年第8期588-590,共3页
Chinese Journal of General Surgery
关键词
甲状腺肿瘤
癌
乳头状
组织学变型
生物学特性
Thyroid neoplasms
Carcinoma, papillary ： Histological variant
Biological characteristic
