家族性非髓样甲状腺癌临床特点分析

杨晓勇; 董莉; 于洋; 李大鹏; 郑向前; 魏松锋; 胡传祥; 程文元; 李亦工; 高明

doi:10.3969/j.issn.1000-8179.2017.10.195

家族性非髓样甲状腺癌临床特点分析

doi: 10.3969/j.issn.1000-8179.2017.10.195

天津医科大学肿瘤医院甲状腺颈部肿瘤科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室，天津市恶性肿瘤临床医学研究中心（天津市300060）

基金项目:

国家自然科学基金项目 81502322

详细信息

作者简介:
杨晓勇专业方向为头颈部肿瘤尤其是甲状腺癌的手术治疗及研究。E-mail：leonyang0104@tom.com

通讯作者:
高明 gaoming68@aliyun.com

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出版历程
- 收稿日期: 2017-02-20
- 修回日期: 2017-03-30
- 刊出日期: 2017-05-30

Clinicopathological features of familial non-medullary thyroid carcinoma

Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China

Funds:

the National Natural Science Foundation of China 81502322

More Information

Corresponding author: Ming GAO; E-mail: gaoming68@aliyun.com

摘要

摘要: 目的探讨家族性非髓样甲状腺癌（familial non-medullary thyroid carcinoma，FNMTC）的临床特点。方法回顾性分析天津医科大学肿瘤医院2011年12月至2015年1月收治的10个不同家系24例FNMTC患者，对照组随机选择此期间182例散发性非髓样甲状腺癌（sporadic non-medullary thyroid carcinoma，SNMTC），对比家族性和散发性之间，家族性第一代与第二代之间临床病理学特征。包括年龄、性别、双侧、多灶性、腺外侵犯、淋巴结转移、是否伴发良性结节及桥本甲状腺炎、预后。结果 FNMTC比SNMTC更易发生双侧病变（66.7% vs. 17.0%，P < 0.001），呈多灶性（45.8% vs. 25.8%，P < 0.050），伴发良性结节（70.8% vs. 40.7%，P < 0.010）和中央淋巴结转移（75.0% vs. 35.2%，P < 0.001）。家族性高危患者的比例高于散发组（33.3% vs. 8.8%，P < 0.05）。FNMTC中第二代患者疾病诊断年龄早于第一代[平均（45.6±10.3）vs.（35.3±5.4），P < 0.05]。结论双侧病变，多灶性，伴发良性结节和高中央淋巴结转移率是FNMTC的临床特征，其第二代患者疾病诊断年龄早于第一代。
- 家族性非髓样甲状腺癌 /
- 多灶性 /
- 遗传早现
Abstract: Objective To analyze the clinicopathological features of familial non-medullary thyroid carcinoma (FNMTC). Methods A retrospective investigation was performed in 24 FNMTC patients from 10 families and 182 sporadic cases who were diagnosed and treated in Tianjin Medical University Cancer Institute and Hospital. Clinicopathological features were analyzed between familial group and sporadic group as well as between the first generation and the later generations of FNMTC patients. Results Compared with the patients with sporadic cancer, FNMTC patients were more likely to exhibit bilaterality (66.7% vs. 17.0%, P < 0.001), multifocality (45.8%vs. 25.8%, P=0.041), benign nodules (70.8% vs. 40.7%, P=0.005), and central lymph node metastasis (75.0% vs. 35.2%, P < 0.001). The proportion of American Thyroid Association (ATA) high-risk patients with FNMTC was higher than the sporadic group (33.3% vs. 8.8%, P=0.019). Comparison of the disease variants between the first generation and the later generations in FNMTC group showed that the latter were presented with disease at an earlier age at the time of diagnosis (mean 45.6±10.3 vs. 35.3±5.4, P=0.031). Conclusion Bilaterality, multifocality, presence of benign nodules, and central lymph node metastasis are special features of FNMTC. Moreover, the second generation has a younger age at the time of diagnosis compared with the first generation of FNMTC patients.
- familial non-medullary thyroid cancer /
- multifocality /
- anticipation

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图 1 TNM分期

Figure 1. TNM staging

Stages Ⅰ-Ⅱ refers to TNMⅠ and Ⅱ, and stages Ⅲ-Ⅳ refers to TNM Ⅲ and Ⅳ. The percentage of TNM staging Ⅰ-Ⅱ in the familial group was 54.2% and 55.5% in the sporadic group

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图 2 ATA的复发风险

Figure 2. ATA recurrence risk

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表 1 FNMTC与SNMTC临床病理特征

Table 1. Clinicopathological characteristics of the FNMTC group and SNMTC

表 2 FNMTC患者第一代和第二代临床病理学特点

Table 2. Clinicopathological characteristics of the first and second generations in FNMTC patients

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