低分化甲状腺癌临床病理特征分析

发布时间：2018-06-03 22:46

本文选题：甲状腺肿瘤 + 病理学　；参考：《中国全科医学》2017年26期

【摘要】：目的探讨低分化甲状腺癌(PDTC)的临床病理特征。方法收集2009年4月—2016年9月安阳市肿瘤医院病理科所有甲状腺癌手术标本502例,学习都灵共识诊断标准并再次由两位高年资医师重新复查组织切片,诊断PDTC 10例。分析10例PDTC患者的临床特征、组织学特点、免疫组化结果。结果 10例患者中男3例,女7例;发病年龄39~74岁,中位发病年龄61岁。10例患者均表现为甲状腺或颈部肿物,伴有吞咽疼痛或声音嘶哑。B超均表现为甲状腺低回声实性结节。10例患者组织结构主要呈实性巢状或片状浸润性生长伴有坏死,低分化部分缺乏乳头状癌核特点,核分裂易见,可伴发有分化好的甲状腺乳头状癌或滤泡性乳头状癌成分。免疫组化结果显示,10例AE1/AE3、CK19阳性表达,8例甲状腺转录因子1(TTF-1)阳性表达,6例甲状腺球蛋白(TG)局灶染色弱阳性,4例波形蛋白染色呈区域阳性表达,10例患者Ki-67增殖指数为10%~50%。随访结果:3例术后局部复发,1例出现肺部转移,3例分别于术后4年、6年及7年死于肿瘤全身转移,其余3例随访时间短未见复发与转移。结论 PDTC是一种独特的且较少见的甲状腺恶性肿瘤,其组织形态特殊,临床预后介于高分化甲状腺癌与未分化甲状腺癌之间。
[Abstract]:Objective to investigate the clinicopathological features of low-differentiated thyroid carcinoma (PDTC). Methods from April 2009 to September 2016, 502 specimens of thyroid carcinoma were collected from Department of Pathology of Anyang Cancer Hospital. The diagnosis criteria of Turin consensus were studied, and tissue sections were re-examined by two senior medical practitioners, and 10 cases of PDTC were diagnosed. The clinical features, histological features and immunohistochemical results of 10 patients with PDTC were analyzed. Results among the 10 patients, 3 were male and 7 female, the onset age was 3974 years old, the median onset age was 61 years old. All of the 10 patients showed hypoechoic solid thyroid nodules. The tissue structure was mainly solid nesting or flake infiltrating growth with necrosis, and the poorly differentiated parts lacked the characteristics of papillary carcinomatous nuclei, and the mitosis was easy to be seen. It can be accompanied by well differentiated papillary thyroid carcinoma or follicular papillary carcinoma. Immunohistochemical results showed that 10 cases of AE1 / AE3 + CK19 positive expression and 8 cases of thyroid transcription factor 1TTF-1) positive expression; 6 cases of thyroid globulin (TGG) weak staining positive staining 4 cases of vimentin positive staining in 10 cases with positive expression of vimentin. The Ki-67 proliferative index of 10 cases was 10 ~ (50). Results 3 cases of postoperative local recurrence and 1 case of pulmonary metastasis occurred in 3 cases. 3 cases died of tumor systemic metastasis in 4 years, 6 years and 7 years, respectively. The other 3 cases had no recurrence or metastasis in the short follow-up period. Conclusion PDTC is a unique and rare thyroid malignant tumor with special histomorphology and its clinical prognosis is between well-differentiated thyroid carcinoma and undifferentiated thyroid carcinoma.
【作者单位】：河南省安阳市肿瘤医院病理科;
【分类号】：R736.1

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