中国实用外科杂志

中国实用外科杂志

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胸腺样分化甲状腺癌16例临床诊治分析

王蕴珺，孙团起，向    俊，王卓颖，李端树，吴    毅   

  1. 复旦大学附属肿瘤医院头颈外科 复旦大学上海医学院肿瘤学系，上海200032
  • 出版日期:2017-01-01 发布日期:2017-01-03

  • Online:2017-01-01 Published:2017-01-03

摘要：

目的    探讨胸腺样分化甲状腺癌的临床特征、诊治和预后。方法    回顾性分析2007-09-01至2015-09-01复旦大学附属肿瘤医院收治16例胸腺样分化甲状腺癌病人临床资料，包括术前检查、治疗方法、病理学检查和免疫组化检测结果以及预后情况。结果    所有病人均行手术治疗，13例行术后放疗。免疫组化检测：CD5、CD117呈阳性，Tg、TTF-1、Calcitonin呈阴性。4例病人失访，12例无进展或死亡［平均随访时间（43.3±28.6）个月］。结论    胸腺样分化甲状腺癌恶性程度低、预后良好。CD5、CD117呈阳性能对其进行有效的鉴别诊断。手术是首选治疗方式，术后放疗可能对减少复发有作用。

关键词: 甲状腺, 胸腺样分化甲状腺癌

Abstract:

Clinical analysis of 16 cases of carcinoma showing thymus-like differentiation of the thyroid        WANG Yunjun, SUN Tuanqi, XIANG Jun, et al. Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Corresponding  author: WU Yi, E-mail: ywu@rddb.shanghai.gov.cn
Abstract    Objective    To analyze the clinicopathologic features, diagnosis, treatment and prognosis of （carcinoma showing thymus-like differentiation of the thyroid， CASTLE）in order to improve the ability of managing it. Method Patients of surgically resected specimens of CASTLE were collected in Head & Neck Surgery Department, Fudan University Shanghai Cancer Centre from 2007-09-01to 2015-09-01. Characteristics of preoperative imagine examination (e.g. ultrasound and CT scan), cytological examination, treatment, histologic and immunohistochemical results and prognosis were analyzed retrospectively. Results    16 patients were included in this study, and all accepted surgery. Postoperative radiotherapy was practiced in 13 patients. The immunohistochemical results showed that CD5, CD117 were almost positive in all patients while Tg, TTF-1, Calcitonin were negative. 4 patients were lost to follow-up. The rest 12 patients were alive without tumor recurrence and metastasis (median follow-up period 43.3±28.6 months). Conclusion    CASTLE is a low malignant tumor with a slow progression and good prognosis. CD5 and CD117 play an important role in differential diagnosis. Radical surgery is the first choice of treating CASTLE while postoperative radiotherapy might reduce local recurrence.

Key words: thyroid, carcinoma showing thymus-like differentiation of the thyroid