甲状腺乳头状癌滤泡亚型临床病理特点的研究

发布时间：2018-06-22 07:51

本文选题：甲状腺乳头状癌 + 滤泡亚型　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:分析甲状腺乳头状癌滤泡亚型(Follicular Variant of Papillary Thyroid Carcinoma,FVPTC)的临床病理特点。探讨其与经典甲状腺乳头状癌(Classical Papillary Thyroid Carcinoma,CPTC)的临床病理特征的差异。方法:收集北京协和医院2009年1月到2014年6月297例甲状腺乳头状癌患者的临床病理资料,由2名病理科医生重新进行病理诊断并进行甲状腺乳头状癌的亚型分类;总结FVPTC的临床病理特点,并比较其与CPTC的临床病理特征的差别,同时比较FVPTC中包膜亚型和非包膜亚型之间临床病理特征的差别。结果:在297例甲状腺乳头状癌患者中,CPTC 148例,FVPTC 149例,分别占全部甲状腺乳头状癌的49.8%、50.2%;女性患者比例分别65.5%、79.2%,平均年龄为43.17±11.77岁、44.9±9.75岁;在149例FVPTC中,包膜型17例、非包膜型132例,分别占11.4%、88.6%,女性患者比例分别为64.7%、81.1%,平均年龄分别为:45.18±7.41岁、44.86±10.03岁。与CPTC相比,FVPTC在女性患者比例(79.2%vs 65.5%,P=0.008),微小癌比例(77.2%vs 62.8%,P=0.007)、淋巴转移率(43.0%vs 58.8%,P=0.006)、Braf基因突变率(76.2%vs 97.6%,P=0.004)方面存在显著性差异;在包膜型和非包膜型FVPTC的比较中发现:超声中恶性病灶边界不清(53.3%vs 79.1%,P=0.048)和声晕比例(33.3%vs 3.1%,P=0.001)两组存在显著性差异;在CPTC和非包膜型FVPTC的比较中发现:女性患者比例(65.5%vs 81.1%,P=0.004)、微小癌灶比例(62.8%vs 77.3%,P=0.009)、淋巴转移率(58.8%vs 42.4%,P=0.006)以及Braf基因突变率(97.6%vs76.3%,P=0.011)上存在显著性差异。结论:FVPTC是很常见的甲状腺乳头状癌的亚型,其有较独特的临床病理特点,较CPTC它的淋巴结转移率、Braf突变率均较低。
[Abstract]:Objective: to analyze the clinicopathological features of follicular variant of papillary thyroid carcinoma (FVPTC). To investigate the difference of clinicopathological features between classical papillary thyroid carcinoma (CPTC) and classical papillary thyroid carcinoma (CPTC). Methods: the clinicopathological data of 297 patients with thyroid papillary carcinoma from January 2009 to June 2014 in Peking Union Hospital were collected. The pathological diagnosis was performed by two pathologists and the subtypes of thyroid papillary carcinoma were classified. To summarize the clinicopathological characteristics of FVPTC, and to compare the differences between FVPTC and CPTC in clinicopathological features, and the differences of clinicopathological characteristics between the capsule subtypes and non-capsular subtypes in FVPTC. Results: of 297 patients with papillary thyroid carcinoma, 149 were CPTC with FVPTC, accounting for 49.8% of all papillary thyroid carcinomas, 79.2% of female patients, with an average age of 43.17 卤11.77 years (44.9 卤9.75 years), and 17 cases of capsular type and 132 cases of non-capsular type in 149 cases of FVPTC. The proportion of female patients was 64.7 and 81.1, the average age was 45.18 卤7.41 years old and 44.86 卤10.03 years old, respectively. Compared with CPTC, there were significant differences in the proportion of female patients (79.2%vs 65.5i), 77.2%vs (77.2%vs 62.8and P0. 007), lymphatic metastasis rate (43.0%vs 58.8 P0. 006) and 76.2%vs 97. 6% (P0.004). In the comparison of the envelope type and the non-encapsulated type, it was found that there were significant differences between the two groups: the boundary of malignant lesions was unclear (53.3%vs 79.1) and the ratio of acoustical halo (33.3%vs 3.1) was significantly different between the two groups. It was found that there were significant differences in the percentage of female patients (65.5%vs 81.1), the proportion of small cancer foci (62.8%vs 77.3P + P0. 009), lymphatic metastasis rate (58.8%vs 42.4G), and Braf gene mutation rate (97.6vs76.3P0. 011) between CPTC and non-encapsulated FVPTC. Conclusion FVPTC is a very common subtype of papillary thyroid carcinoma, which has unique clinicopathological characteristics and has lower lymph node metastasis rate and Braf mutation rate than CPTC.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R736.1

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