甲状腺乳头状癌滤泡亚型声像图及临床病理特征分析

摘要

目的：分析甲状腺乳头状癌滤泡亚型临床病理特征、声像图特征。方法：回顾性分析74例甲状腺乳头状癌滤泡亚型患者（排除小于1 cm的微小癌）的临床病理和超声声像图资料。以同期甲状腺乳头状癌经典型295例、甲状腺滤泡状癌患者21例作为对照纳入本研究。结果：甲状腺乳头状癌滤泡亚型共74例，根据超声声像图不同滤泡亚型分为类经典型亚组55例（74.3%），类腺瘤样亚组19例（25.7%）。甲状腺乳头状癌滤泡亚型的淋巴结转移率较甲状腺滤泡状癌常见，但较甲状腺乳头状癌经典型少见（P<0.05）。甲状腺乳头状癌经典型、甲状腺乳头状癌滤泡亚型和甲状腺滤泡状癌的远处转移率分别为1.4%、2.7%和4.8%。两亚组肿瘤大小、多灶癌的概率、甲状腺外侵犯、淋巴结转移率及TNM分期差异有统计学意义（P<0.05）。结论：拥有超声恶性征象甲状腺乳头状癌滤泡亚型比无恶性征象的更具侵袭性，超声可以帮助预测其临床生物学表现。%Objective:To analyze the clinical pathological and ultrasonographic (US) features of follicular variant of papillary thyroid carcinoma(FV-PTC). Methods:Clinical pathological and ultrasonographic data of 74 FV-PTC patients(microcarcinoma less than 1 cm were excluded) were retrospectively analyzed. Two hundreds and ninty five patients with classical papillary thyroid carcinoma (C-PTCs) and 21 patients with follicular thyroid carcinoma (FTCs) were included as controls meanwhile. Results:Seventy four FV-PTC surgical cases were identified. Of the 74 FV-PTCs, 55(74.3%) were PTC-featured and 19 (25.7%) were FN-featured. Lymph-node metastases were more frequent in FV-PTC than in FTC, but significantly less common than in C-PTC (P<0.05). Distant metastasis rates were 2.7%for patients with FV-PTC, 1.4%for patients with C-PTC, and 4.8%for pateints FTC. Significant differences were found between PTC-featured and FN featured groups in tumor size, multifocality rate, extrathyroidal extension, lymph node metastasis and TNM staging (P<0.05). Conclusion:FV-PTC with malignant US features seems to behave in a more aggressive fashion than FV-PTC without malignant US features. US can help predict the behavior of FV-PTC.