甲状腺乳头状癌远处转移16例临床病理特征分析

目的探讨甲状腺乳头状癌合并远处转移患者的临床病理特点及预后。 方法收集2003年1月至2017年12月在中山大学附属第一医院住院诊治病例资料完整的16例甲状腺乳头状癌合并远处转移患者，回顾性分析其临床和病理特点及预后。 结果同步转移13例，其中2例老年患者死亡，中位数年龄为35岁。肿瘤的平均直径为（2.9±1.89）cm，转移部位多为肺转移，11例存在颈部淋巴结转移，占总数的68.75%。转移淋巴结的数量中位数达到9.75枚。转移淋巴结的平均最大直径为（2.5±1.50）cm。10例患者超声显示病灶为血供丰富。8例甲状腺球蛋白（TG）定量明显升高。 结论甲状腺乳头状癌远处转移可能是致命的。对于原发肿瘤直径较大并且较多肿大淋巴结、血供丰富、TG升高的患者要注意远处转移特别是肺转移的发生。

Analysis of clinical pathological features and prognosis of 16 cases of papillary thyroid carcinoma withdistant metastasis

ObjectiveTo evaluate the clinicopathological features and identify the risk factors for distant metastasis in patients with papillary thyroid carcinoma (PTC). MethodsThe medical records of sixteen patients who were diagnosed with PTC with distant metastasis from January 2003 to December 2017 were reviewed. Bilateral total thyroidectomy was performed in 16 patients. A retrospective analysis was performed on clinical and pathological features and prognosis. ResultsOf the 16 patients with distant metastasis, thirteen had synchronous metastasis. Two patients died of thyroid carcinoma. Thirteen patients had lung metastases. The median age is 35 years. The average diameter of the tumor was (2.9±1.89) cm. Eleven patients had lateral cervical lymph node metastases. The average number of metastatic lymph nodes reached 9.75. The average maximum diameter of metastatic lymph nodes was (2.5±1.50) cm. Vascularity at power Doppler ultrasonography was found in 10 cases, accounting for 90.9% (10/11). Thyroglobulin (TG) was significantly increased in 8 patients. ConclusionsDistant metastasis of PTC can be fatal. More attention should be paid for patients with large diameter primary tumor and more enlarged lymph nodes, vascularity at Doppler ultrasonography and elevated TG, the occurrence of distant metastasis, especially lung metastasis.