Whole Tumor Capsule Is Prognostic of Very Good Outcome in the Classical Variant of Papillary Thyroid Cancer

被引：14

作者：

Giani, Carlotta ^{[1
]}

Torregrossa, Liborio ^{[2
]}

Ramone, Teresa ^{[1
]}

Romei, Cristina ^{[1
]}

Matrone, Antonio ^{[1
]}

Molinaro, Eleonora ^{[1
]}

Agate, Laura ^{[1
]}

Materazzi, Gabriele ^{[3
]}

Piaggi, Paolo ^{[4
]}

Ugolini, Clara ^{[2
]}

Basolo, Fulvio ^{[2
]}

Ciampi, Raffaele ^{[1
]}

Elisei, Rossella ^{[1
]}

机构：

[1] Univ Hosp Pisa, Dept Clin & Expt Med, Unit Endocrinol, Via Paradisa 2, I-56124 Pisa, Italy

[2] Univ Hosp Pisa, Dept Surg Med Mol Pathol & Crit Area, Pathol Unit, I-56126 Pisa, Italy

[3] Univ Hosp Pisa, Dept Surg Med Mol Pathol & Crit Area, Surg Unit, I-56124 Pisa, Italy

[4] Univ Pisa, Dept Informat Engn, I-56122 Pisa, Italy

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2021年 / 106卷 / 10期

关键词：

whole tumor capsule; papillary thyroid cancer; follicular variant; classical variant; ENCAPSULATED FOLLICULAR VARIANT; NUCLEAR FEATURES; BRAF MUTATION; CARCINOMA; ASSOCIATION; NEOPLASM; RECURRENCE; DIAGNOSIS; SUBTYPES; IMPACT;

D O I：

10.1210/clinem/dgab396

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context: Tumor capsule integrity is becoming a relevant issue to predict the biological behavior of human tumors, including thyroid cancer. Objective: This work aims to verify whether a whole tumor capsule in the classical variant of papillary thyroid carcinoma (CVPTC) could have as a predictive role of a good outcome as for follicular variant (FVPTC). Methods: FVPTC (n=600) and CVPTC (n=554) cases were analyzed. We distinguished between encapsulated-FVPTC (E-FVPTC) and encapsulated-CVPTC (E-CVPTC) and, thereafter, invasive (Ei-FVPTC and Ei-CVPTC) and noninvasive (En-FVPTC and En-CVPTC) tumors, according to the invasion or integrity of the tumor capsule, respectively. Cases without a tumor capsule were indicated as invasive-FVPTC (I-FVPTC) and invasive-CVPTC (I-CVPTC). The subgroup of each variant was evaluated for BRAF mutations. Results: E-FVPTC was more frequent than E-CVPTC (P<.001). No differences were found between En-FVPTC and En-CVPTC or between Ei-FVPTC and Ei-CVPTC. After 18 years of follow-up, a greater number of not-cured cases were observed in Ei-CVPTC with respect to Ei-FVPTC, but not in En-CVPTC to En-FVPTC. Multivariate clustering analysis showed that En-FVPTC, En-CVPTC, and Ei-FVPTC have similar features but different from I-FVPTC and I-CVPTC and, to a lesser extent, from Ei-CVPTC. A total of 177 of 614 (28.8%) cases were BRAF(V600E) mutated, and 10 of 614 (1.6%) carried BRAF-rare alterations. A significantly higher rate of En-CVPTC (22/49, 44.9%) than En-FVPTC (15/195, 7.7%) (P<.0001) were BRAF(V600E) mutated. Conclusion: En-CVPTC is less prevalent than En-FVPTC. However, it has good clinical/pathological behavior comparable to En-FVPTC. This finding confirms the good prognostic role of a whole tumor capsule in CVPTC as well. New nomenclature for En-CVPTC, similar to that introduced for En-FVPTC (ie, noninvasive follicular thyroid neoplasm with papillary-like nuclear features; NIFTP) could be envisaged.

引用

页码：E4072 / E4083

页数：12

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