| 具有乳头状核特征的非浸润性甲状腺滤泡性肿瘤临床病理特征分析 |
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| 引用本文： | 杨宁宁,黄雨晨,闫文天,陈洪春,潘成武,贾建光,冯振中.具有乳头状核特征的非浸润性甲状腺滤泡性肿瘤临床病理特征分析[J].中国肿瘤临床,2020,47(17):886-889. |
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| 作者姓名： | 杨宁宁 黄雨晨 闫文天 陈洪春 潘成武 贾建光 冯振中 |
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| 作者单位： | ①.蚌埠医学院第一附属医院病理科(安徽省蚌埠市 233000) |
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| 摘 要： | 目的: 探讨具有乳头状核特征的非浸润性甲状腺滤泡性肿瘤（non-invasive follicular thyroid neoplasm with papillary-like nu-clear features，NIFTP）的临床病理学特征。 方法: 回顾性分析2012年1月至2017年12月蚌埠医学院第一附属医院7例NIFTP患者的临床表现、组织形态学、免疫组织化学、分子遗传和预后特征，并复习相关文献。 结果: 7例NIFTP患者中，男性3例，女性4例，年龄36~54岁，中位年龄50岁；肿瘤直径0.2~3.0 cm，中位直径1.2 cm。单发结节4例，双发结节2例，多发结节1例。7例形态学表现为包膜完整、边界清晰，无血管和包膜浸润；肿瘤细胞核大、拥挤，部分可见核沟、核内假包涵体及毛玻璃样核，具有甲状腺乳头状癌（papillary thyroid carcinoma，PTC）的核特征。免疫组织化学缺乏特异性表达，诊断价值有限，Ki-67增殖指数低。荧光定量PCR检测KRAS和NRAS基因突变2例，均无BRAF V600E突变。5例随访21~74个月，无复发和转移，2例失访。 结论: NIFTP是一种极低度恶性潜能的甲状腺交界性肿瘤，具有特定形态学表现和惰性生物学行为，RAS基因突变检测有助于诊断。
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| 关 键 词： | 甲状腺交界性肿瘤 乳头样核特征 非浸润性 甲状腺滤泡性肿瘤 临床病理特征 |
| 收稿时间： | 2020-05-08 |
Clinicopathological features of non-invasive thyroid follicular tumors with papillarylike nuclear features |
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| Affiliation: | ①.Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China②.Department of Pathology, Bengbu Medical College, Bengbu 233000, China③.Department of Oncology Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China |
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| Abstract: | Objective: To investigate the clinicopathological features of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Methods: From January 2012 to December 2017 in First Affiliated Hospital of Bengbu Medical College, the clinical manifestations, histomorphology, immunohistochemistry, molecular genetics, and prognosis of 7 cases with NIFTP were retrospectively reviewed, along with the relevant literature. Results: Of the 7 NIFTP cases, 4 were females and 3 males. The age of onset ranged from 36 to 54 years (median 50 years). The tumor diameters ranged from (0.2-3.0) cm (median 1.2 cm). Solitary nodules were found in 4 cases, double nodules in 2 cases and multiple nodules in 1 case. In all 7 cases, the capsule was intact, the boundary was clear, and there was no vascular and capsule infiltration. The nucleus of the tumor was large and crowded. Some nuclear sulci, nuclear pseudo inclusion bodies, and ground glass-like nuclei could be seen, which had the nuclear characteristics of papillary thyroid carcinoma. Lacking of tissue-specific expression, diagnosis value of immunohistochemical staining was limited. The proliferation index of Ki-67 was low. Two cases of KRAS and NRAS gene mutations were detected by quantitative fluorescence polymerase chain reaction, but no BRAFV600E mutations were found. During the follow-up period of 21 to 74 months, 5 cases displayed no recurrence or metastasis, and 2 cases were lost to follow-up. Conclusions: NIFTP is a borderline thyroid tumor with very low malignant potential. It has specific morphological manifestations and inert biological behavior. Detection of the RAS gene mutation is helpful for the diagnosis of NIFTP. |
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