协和医学杂志

2012, (01) 72-76

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低分化甲状腺癌的临床病理
Clinicopathological Characteristics of Poorly Differentiated Thyroid Carcinoma

孙健;李文波;杨堤;成殷;崔全才;
SUN Jian1,LI Wen-bo2,YANG Di1,CHENG Yin1,CUI Quan-cai1 1Department of Pathology,2Department of Diagnostic Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

摘要(Abstract):

目的观察低分化甲状腺癌(poorly differentiated thy roid carcinoma,PDTC)的临床病理特点。方法回顾性分析北京协和医院12例符合都灵诊断共识的PDTC临床、影像和病理学资料,并采用EnVision法进行免疫组织化学标记。结果 12例PDTC病例中11例为女性,1例为男性,平均发病年龄53.6岁。临床均表现为前颈部肿块,B超示肿物为低回声实性结节。5例患者肿瘤主要呈粱状生长,4例主要呈岛状生长,3例主要呈实性生长。免疫组化,11例阳性表达TTF1;10例阳性表达甲状腺球蛋白;4例P53弥漫阳性表达,3例局灶阳性表达;Ki67增殖指数3%~25%不等。随访期间,2例患者分别于术后4年及术后7.5年死于肿瘤播散。结论 PDTC是一种独特的且较少见的甲状腺恶性肿瘤,其临床病理特点介于高分化甲状腺癌与未分化甲状腺癌之间。
Objective To investigate the clinicopathological characteristics of poorly differentiated thyroid carcinoma(PDTC).Methods The clinical and pathological features as well as the imaging findings of 12 cases of PDTC were retrospectively reviewed.Results The 12 patients,1 man and 11 women,with an average age of 53.6 years,presented with painless mass at the anterior neck.Grossly,the tumor had a nodular appearance.Histologically,the predominantly insular pattern was found in 4 tumors,the trabecular architecture in 5 tumors,and the solid flake architecture in 3 tumors.Immunohistochemically,TTF1 was positive in 11 cases.Thyroglobulin expression was noted in 10 cases.P53 immunostaining showed diffuse positivity in 4 cases and focal positivity in 3 cases.The Ki67 proliferative index ranged from 3% to 25%.Two patients died of the tumor progression 4 and 7.5 years after the surgery,respectively.Conclusion PDTC is a rare disease with clinicopathological characteristics intermediate between follicular/papillary and anaplastic carcinomas.

关键词(KeyWords): 甲状腺;低分化癌;岛状癌
thyroid;poorly differentiated carcinoma;insular carcinoma

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作者(Author): 孙健;李文波;杨堤;成殷;崔全才;
SUN Jian1,LI Wen-bo2,YANG Di1,CHENG Yin1,CUI Quan-cai1 1Department of Pathology,2Department of Diagnostic Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

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