Differential Clinicopathological Risk and Prognosis of Major Papillary Thyroid Cancer Variants

被引：180

作者：

Shi, Xiaoguang ^{[1
]}

Liu, Rengyun ^{[1
]}

Basolo, Fulvio ^{[2
]}

Giannini, Riccardo ^{[2
]}

Shen, Xiaopei ^{[1
]}

Teng, Di ^{[1
]}

Guan, Haixia ^{[3
,4
]}

Shan, Zhongyan ^{[3
,4
]}

Teng, Weiping ^{[3
,4
]}

Musholt, Thomas J. ^{[5
]}

Al-Kuraya, Khawla ^{[6
]}

Fugazzola, Laura ^{[7
,8
]}

Colombo, Carla ^{[7
,8
]}

Kebebew, Electron ^{[9
]}

Jarzab, Barbara ^{[10
]}

Czarniecka, Agnieszka ^{[10
]}

Bendlova, Bela ^{[11
]}

Sykorova, Vlasta ^{[11
]}

Sobrinho-Simoes, Manuel ^{[12
,13
]}

Soares, Paula ^{[12
,13
]}

Shong, Young Kee ^{[14
]}

Kim, Tae Yong ^{[14
]}

Cheng, Sonia ^{[15
]}

Asa, Sylvia L. ^{[15
]}

Viola, David ^{[16
]}

Elisei, Rossella ^{[16
]}

Yip, Linwah ^{[17
]}

Mian, Caterina ^{[18
]}

Vianello, Federica ^{[19
]}

Wang, Yangang ^{[20
]}

Zhao, Shihua ^{[20
]}

Oler, Gisele ^{[21
]}

Cerutti, Janete M. ^{[21
]}

Puxeddu, Efisio ^{[22
]}

Qu, Shen ^{[23
]}

Wei, Qing

Xu, Huixiong ^{[24
]}

O'Neill, Christine J. ^{[25
]}

Sywak, Mark S. ^{[25
]}

Clifton-Bligh, Roderick ^{[25
]}

Lam, Alfred K. ^{[26
]}

Riesco-Eizaguirre, Garcilaso ^{[27
,28
,29
,30
]}

Santisteban, Pilar ^{[29
,30
]}

Yu, Hongyu ^{[31
]}

Tallini, Giovanni ^{[32
]}

Holt, Elizabeth H. ^{[33
]}

Vasko, Vasily ^{[34
]}

Xing, Mingzhao ^{[1
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Div Endocrinol Diabet & Metab, Lab Cellular & Mol Thyroid Res,Dept Med, Baltimore, MD 21287 USA

[2] Dept Surg, Div Pathol, I-56126 Pisa, Italy

[3] China Med Univ, Hosp 1, Endocrine Inst, Shenyang 110001, Liaoning, Peoples R China

[4] China Med Univ, Hosp 1, Dept Endocrinol & Metab, Liaoning Prov Key Lab Endocrine Dis, Shenyang 110001, Liaoning, Peoples R China

[5] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Endocrine Surg, D-55101 Mainz, Germany

[6] King Faisal Specialist Hosp & Res Ctr, Res Ctr, Human Canc Genom Res, Riyadh 12713, Saudi Arabia

[7] IRCCS Ca Granda Policlin, Fdn Inst Ricovero & Cura Carattere Sci, Milan, Italy

[8] Univ Milan, Dept Pathophysiol & Transplantat, I-20122 Milan, Italy

[9] NCI, Endocrine Oncol Branch, Ctr Canc Res, NIH, Bethesda, MD 20892 USA

[10] Maria Sklodowska Curie Mem Canc Ctr & Inst Oncol, PL-44101 Gliwice, Poland

[11] Inst Endocrinol, Dept Mol Endocrinol, Prague 11694, Czech Republic

[12] Univ Porto Ipatimup, Inst Mol Pathol & Immunol, P-4200319 Oporto, Portugal

[13] Univ Porto, Fac Med, P-4200319 Oporto, Portugal

[14] Univ Ulsan, Coll Med, Seoul, South Korea

[15] Univ Hlth Network, Dept Pathol, Toronto, ON M5G 2C4, Canada

[16] Univ Pisa, WHO, Endocrine Unit,Dept Clin & Expt Med, Collaborating Ctr Study & Treatment Thyroid Dis &, I-56124 Pisa, Italy

[17] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15213 USA

[18] Univ Padua, Endocrinol Unit, Dept Med, I-35128 Padua, Italy

[19] IRCCS, Veneto Inst Oncol, I-35128 Padua, Italy

[20] Qingdao Univ, Affiliated Hosp, Dept Endocrinol, Qingdao 266003, Peoples R China

[21] Univ Fed Sao Paulo, Div Genet, Genet Bases Thyroid Tumor Lab, BR-04039032 Sao Paulo, Brazil

[22] Univ Perugia, Dept Internal Med, I-06100 Perugia, Italy

[23] Tongji Univ, Sch Med, Shanghai Peoples Hosp 10, Dept Endocrinol,Thyroid Inst, Shanghai 200072, Peoples R China

[24] Tongji Univ, Sch Med, Shanghai Peoples Hosp 10, Dept Med Ultrasound,Thyroid Inst, Shanghai 200072, Peoples R China

[25] Univ Sydney, Endocrine Surg Unit, Sydney, NSW 2052, Australia

[26] Griffith Univ Gold Coast, Canc Mol Pathol Menzies Hlth Inst Queensland, Southport, Qld 4215, Australia

[27] Hosp La Paz, Hlth Res Inst, Madrid 28029, Spain

[28] Hosp Univ Mostoles, Madrid 28029, Spain

[29] CSIC, Spanish Council Res, Biomed Res Inst, Alberto Sols, Madrid 28029, Spain

[30] Autonomous Univ Madrid, Madrid 28029, Spain

[31] Second Mil Med Univ, Changzheng Hosp, Dept Pathol, Shanghai 200003, Peoples R China

[32] Univ Bologna, Osped Bellaria, Anat Pathol Unit, Dept Med, I-40139 Bologna, Italy

[33] Yale Univ, Sch Med, Dept Internal Med, Endocrine Sect, New Haven, CT 06520 USA

[34] Uniformed Serv Univ Hlth Sci, Dept Pediat, Bethesda, MD 20814 USA

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2016年 / 101卷 / 01期

基金：

巴西圣保罗研究基金会; 美国国家卫生研究院;

关键词：

BRAF V600E MUTATION; TALL-CELL VARIANT; NEEDLE-ASPIRATION BIOPSY; FOLLICULAR VARIANT; BRAF(V600E) MUTATION; SURGICAL-TREATMENT; CLINICAL-FEATURES; CARCINOMA; ASSOCIATION; RECURRENCE;

D O I：

10.1210/jc.2015-2917

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: This was a retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33-56 y) and median follow-up time of 37 months (interquartile range, 15-82 mo). Results: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P < .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC > CPTC >> FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66-132.26) and 24.61 (12.31-49.21), 34.46 (30.71-38.66), and 5.87 (4.37-7.88), and 24.73 (18.34-33.35) and 1.68 (0.54-5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07-11.11) and 14.96 (95% CI, 3.93-56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC >> FVPTC, providing important clinical implications for specific variant-based management of PTC.

引用

页码：263 / 273

页数：11

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