本文選題：甲狀腺腫瘤 + 病理學(xué)��； 參考：《中國全科醫(yī)學(xué)》2017年26期

【摘要】：目的探討低分化甲狀腺癌(PDTC)的臨床病理特征。方法收集2009年4月—2016年9月安陽市腫瘤醫(yī)院病理科所有甲狀腺癌手術(shù)標(biāo)本502例,學(xué)習(xí)都靈共識診斷標(biāo)準(zhǔn)并再次由兩位高年資醫(yī)師重新復(fù)查組織切片,診斷PDTC 10例。分析10例PDTC患者的臨床特征、組織學(xué)特點、免疫組化結(jié)果。結(jié)果 10例患者中男3例,女7例;發(fā)病年齡39~74歲,中位發(fā)病年齡61歲。10例患者均表現(xiàn)為甲狀腺或頸部腫物,伴有吞咽疼痛或聲音嘶啞。B超均表現(xiàn)為甲狀腺低回聲實性結(jié)節(jié)。10例患者組織結(jié)構(gòu)主要呈實性巢狀或片狀浸潤性生長伴有壞死,低分化部分缺乏乳頭狀癌核特點,核分裂易見,可伴發(fā)有分化好的甲狀腺乳頭狀癌或濾泡性乳頭狀癌成分。免疫組化結(jié)果顯示,10例AE1/AE3、CK19陽性表達(dá),8例甲狀腺轉(zhuǎn)錄因子1(TTF-1)陽性表達(dá),6例甲狀腺球蛋白(TG)局灶染色弱陽性,4例波形蛋白染色呈區(qū)域陽性表達(dá),10例患者Ki-67增殖指數(shù)為10%~50%。隨訪結(jié)果:3例術(shù)后局部復(fù)發(fā),1例出現(xiàn)肺部轉(zhuǎn)移,3例分別于術(shù)后4年、6年及7年死于腫瘤全身轉(zhuǎn)移,其余3例隨訪時間短未見復(fù)發(fā)與轉(zhuǎn)移。結(jié)論 PDTC是一種獨特的且較少見的甲狀腺惡性腫瘤,其組織形態(tài)特殊,臨床預(yù)后介于高分化甲狀腺癌與未分化甲狀腺癌之間。
[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.
【作者單位】： 河南省安陽市腫瘤醫(yī)院病理科;
【分類號】：R736.1

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