| 郑正,安风仙,罗科,等.不同病理分级的甲状腺髓样癌临床病理特征及预后分析[J].安徽医药,2025,29(12):2427-2430. |
| 不同病理分级的甲状腺髓样癌临床病理特征及预后分析 |
| Clinicopathologic characteristics and prognosis analysis of thyroid medullary carcinoma with different pathological grades |
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| DOI：10.3969/j.issn.1009-6469.2025.12.020 |
| 中文关键词: 甲状腺髓样癌 病理分级 临床病理特征 甲状腺髓样癌国际分级系统(IMTCGS) 预后 |
| 英文关键词: Medullary carcinoma of the thyroid Pathological grading Clinical and pathological characteristics International medullary thyroid cancer grading system(IMTCGS) Prognosis |
| 基金项目:山东省医药卫生科技发展计划项目( 2018WS422) |
| 作者 | 单位 | E-mail | | 郑正 | 聊城市人民医院,病理科,山东聊城 252000 | | | 安风仙 | 聊城市人民医院,病理科,山东聊城 252000 | | | 罗科 | 聊城市人民医院,病理科,山东聊城 252000 | | | 刘霞 | 聊城市人民医院,病理科,山东聊城 252000 | | | 徐丽 | 干细胞与再生医学实验室,山东聊城 252000 | | | 李迎雪 | 聊城市人民医院,病理科,山东聊城 252000 | 406894011@qq.com |
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| 中文摘要: |
| 目的探讨不同病理分级的散发性甲状腺髓样癌(sMTC)的临床病理特征及预后情况。方法回顾性分析聊城市人民医院 2011年 1月至 2023年 8月收治的 73例 sMTC病人的临床病理特征，并采用甲状腺髓样癌国际分级系统( IMTCGS)对其进行病理分级，探讨低级别和高级别 MTC的临床病理特征和预后情况。结果 73例 sMTC病人中 69.8%(51/73)为单发病灶， 46.6%(34/73)腺外侵犯， 11%(8/73)可见神经侵犯， 15.1%(11/73)可见脉管侵犯，淋巴结转移率( LNR)>0.3的有 35.6%(26/73)，且 LNR与肿瘤长径显著相关( P<0.05)美国癌症联合委员会( AJCC)分期为 Ⅲ和Ⅳ期的病例共有 40例( 54.8%)13例( 17.8%)术后复发或死亡。其中，高级别 MTC和低，级别 MTC分别为 8例( 11%)和 65例( 89%)高级别 MTC病人 AJCCⅣ期发，生率、淋巴结转移比率明显高于低级别 MTC病人( P<0.05)。高级别病人总生存率和无病生存率，明显低于低级别病人( P<0.05)。结论 sMTC总生存率较高，但高级别 MTC病人的预后明显比低级别病人差，建议临床对高级别病人进行更长期、更密切地随访，及早发现疾病进展。 |
| 英文摘要: |
| Objective To investigate the clinicopathological features and prognosis of sporadic medullary thyroid carcinoma (sMTC)with different pathological grades.Methods A retrospective analysis was conducted on the clinicopathological features of 73 patientswith sMTC admitted to Liaocheng People's Hospital from January 2011 to August 2023, and the International medullary thyroid cancergrading system (IMTCGS) was used to classify them for pathological classification, exploring the clinicopathological characteristics andprognosis of low-grade and high-grade MTC.Results Among the 73 cases of sMTC patients, 69.8% (51/73) had single lesion, 46.6%(34/73) had extragadenial invasion, 11% (8/73) had nerve invasion, and 15.1% (11/73) had vascular invasion. There were 35.6% (26/73) with lymph node metastasis rate (LNR) >0.3, and LNR was significantly correlated with tumor diameter (P<0.05). There were 40(54.8%) cases with AJCC stage Ⅲ and Ⅳ, and 13 (17.8%) cases with postoperative recurrence or death. Among them, high-grade MTC and low-grade MTC were 8 cases (11%) and 65 cases (89%) respectively. The incidence of AJCC stage Ⅳ and the lymph node metasta-sis rate were significantly higher in high-grade MTC patients than those in low-grade MTC patients (P<0.05). The overall survival rate and disease-free survival rate of high-grade patients were significantly lower than those of low-grade patients (P<0.05). Conclusions The overall survival rate of sMTC is higher, but the prognosis of high-grade MTC patients is significantly worse than that of low-grade MTC patients. It is recommended to conduct longer-term and closer follow-up on high-grade patients in clinical practice to detect dis-ease progression early. |
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