Journal of Surgery Concepts & Practice ›› 2021, Vol. 26 ›› Issue (06): 504-509.doi: 10.16139/j.1007-9610.2021.06.009
• Experts forum • Previous Articles Next Articles
TANG Juan, LIU Zhiyan(
)
Received:2021-09-27
Online:2021-11-25
Published:2022-07-27
Contact:
LIU Zhiyan
E-mail:zhiyanliu@shsmu.edu.cn
CLC Number:
TANG Juan, LIU Zhiyan. Differentiated thyroid carcinoma: 4th edition WHO pathological classification and future[J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 504-509.
| 分型 | 特征性肿瘤细胞比例 | 主要形态学特征 | |
|---|---|---|---|
| 高侵袭性 | 高细胞型 | ≥30% | 拉长的滤泡或具有双轨征的乳头;肿瘤细胞高度为宽度的2~3倍;嗜酸性胞质;肿瘤细胞边界清晰 |
| 柱状细胞型 | ≥30% | 肿瘤细胞多为假复层柱状;TTF-1表达各异，可表达CDX2;预后与肿瘤是否有包膜、是否浸润性生长有关 | |
| 鞋钉型 | ≥30% | 复杂多级乳头和微乳头结构;肿瘤细胞嗜酸性胞质，细胞核位于顶端 | |
| 实体/梁状型 | 100%或接近100% | 多见于年轻人或具有放射暴露史者;与肺转移有关;成人死亡率略增高 | |
| 惰性 | 滤泡亚型 | 100% | 无真性乳头、滤泡结构，具有PTC细胞核特点 |
| 弥漫硬化型 | 无要求 | 广泛砂砾体、弥漫纤维化、淋巴管内癌栓;广泛鳞状上皮化生;淋巴细胞性甲状腺炎 | |
| 微小乳头状癌 | 直径（单个肿瘤或多个肿瘤总和）≤1 cm | 具有PTC细胞核特征 | |
| 梭形细胞型 | 5%~95%的梭形细胞 | 免疫表型表达CK和TTF-1，无坏死和核分裂像;无含铁血黄素沉着 | |
| 包裹型 | 无要求 | 有完整包膜，无论是否浸润 | |
| 结节性筋膜炎 样型 | 结节性筋膜炎样/纤维瘤病样间质 | ||
| Warthin样型 | 乳头被覆嗜酸性大肿瘤细胞，间质富于淋巴细胞;淋巴细胞性甲状腺炎背景;部分肿瘤中央囊性变 | ||
| 嗜酸细胞型 | 十分罕见，嗜酸性胞质，需与高细胞型鉴别 | ||
| 透明细胞型 | 透明胞质，可见部分嗜酸性细胞 | ||
| 筛状桑葚型 | 乳头、滤泡或实性结构，通常腔内缺乏胶质;肿瘤细胞多为柱状，核沟与核内包涵体数量不等;可见典型桑葚体;肿瘤细胞表达TTF-1，甲状腺球蛋白不表达或仅局灶表达;β-catenin异常表达于肿瘤细胞核 |
| [1] | Davies L, Morris LG, Haymart M, et al. American Associa-tion of Clinical Endocrinologists and american college of endocrinology disease state clinical review: the increasing incidence of thyroid cancer[J]. Endocr Pract, 2015, 21(6):686-696. |
| [2] | Jung CK, Little MP, Lubin JH, et al. The increase in thyroid cancer incidence during the last four decades is accompanied by a high frequency of BRAF mutations and a sharp increase in RAS mutations[J]. J Clin Endocrinol Metab, 2014, 99(2):E276-E285. |
| [3] | Furukawa K, Preston D, Funamoto S, et al. Long-term trend of thyroid cancer risk among Japanese atomic-bomb survivors: 60 years after exposure[J]. Int J Cancer, 2013, 132(5):1222-1226. |
| [4] | Cahoon EK, Nadyrov EA, Polyanskaya ON, et al. Risk of thyroid nodules in residents of Belarus exposed to Chernobyl fallout as children and adolescents[J]. J Clin Endocrinol Metab, 2017, 102(7):2207-2217. |
| [5] | La Vecchia C, Malvezzi M, Bosetti C, et al. Thyroid cancer mortality and incidence: a global overview[J]. Int J Cancer, 2015, 136(9):2187-2195. |
| [6] | Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018[J]. CA Cancer J Clin, 2018, 68(1):7-30. |
| [7] | Hoadley KA, Yau C, Hinoue T, et al. Cell-of-origin patterns dominate the molecular classification of 10,000 tumors from 33 types of cancer[J]. Cell, 2018, 173(2):291-304, e6. |
| [8] | Cancer Genome Atlas Research Network. Integrated genomic characterization of papillary thyroid carcinoma[J]. Cell, 2014, 159(3):676-690. |
| [9] | Cavadas B, Pereira JB, Correia M, et al. Genomic and transcriptomic characterization of the mitochondrial-rich oncocytic phenotype on a thyroid carcinoma background[J]. Mitochondrion, 2019, 46:123-133. |
| [10] | Liang J, Cai W, Feng D, et al. Genetic landscape of pa-pillary thyroid carcinoma in the Chinese population[J]. J Pathol, 2018, 244(2):215-226. |
| [11] | Yoo SK, Lee S, Kim SJ, et al. Comprehensive analysis of the transcriptional and mutational landscape of follicular and papillary thyroid cancers[J]. PLoS Genet, 2016, 12(8):e1006239. |
| [12] | Nicolson NG, Murtha TD, Dong W, et al. Comprehensive genetic analysis of follicular thyroid carcinoma predicts prognosis independent of histology[J]. J Clin Endocrinol Metab, 2018, 103(7):2640-2650. |
| [13] | Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132. |
| [14] | Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012[J]. CA Cancer J Clin, 2015, 65(2):87-108. |
| [15] | Póvoa AA, Teixeira E, Bella-Cueto MR, et al. Genetic determinants for prediction of outcome of patients with papillary thyroid carcinoma[J]. Cancers (Basel), 2021, 13(9):2048. |
| [16] | Lloyd R, Osamura R, Klöppel G, et al. WHO Classification of Tumours: Pathology and Genetics of Tumours of Endocrine Organs[M]. 4th ed. Lyon: IARC, 2017. |
| [17] | Nikiforov YE, Seethala RR, Tallini G, et al. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: a paradigm shift to reduce overtreatment of indolent tumors[J]. JAMA Oncol, 2016, 2(8):1023-1029. |
| [18] | Giordano TJ. Genomic hallmarks of thyroid neoplasia[J]. Annu Rev Pathol, 2018, 13:141-162. |
| [19] | Bychkov A, Hirokawa M, Jung CK, et al. Low rate of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice[J]. Thyroid, 2017, 27:983-984. |
| [20] | Bychkov A, Jung CK, Liu Z, et al. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice: perspectives for surgical pathology and cytopathology[J]. Endocr Pathol, 2018, 29(3):276-288. |
| [21] | Liu Z, Bychkov A, Jung CK, et al. Interobserver and intraobserver variation in the morphological evaluation of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice[J]. Pathol Int, 2019, 69(4):202-210. |
| [22] | Ghossein R, Barletta JA, Bullock M, et al. Data set for reporting carcinoma of the thyroid: recommendations from the international collaboration on cancer reporting[J]. Hum Pathol, 2021, 110:62-72. |
| [23] | Ito Y, Hirokawa M, Fukushima M, et al. Prevalence and prognostic significance of poor differentiation and tall cell variant in papillary carcinoma in Japan[J]. World J Surg, 2008, 32(7):1535-1543; |
| discussion 1544-1535. | |
| [24] | Michels JJ, Jacques M, Henry-Amar M, et al. Prevalence and prognostic significance of tall cell variant of papillary thyroid carcinoma[J]. Hum Pathol, 2007, 38(2):212-219. |
| [25] | Ghossein R, Livolsi VA. Papillary thyroid carcinoma tall cell variant[J]. Thyroid, 2008, 18(11):1179-1181. |
| [26] | Gunalp B, Okuyucu K, Ince S, et al. Impact of tall cell variant histology on predicting relapse and changing the management of papillary thyroid carcinoma patients[J]. Hell J Nucl Med, 2017, 20(2):122-127. |
| [27] | Giordano TJ. The cancer genome atlas research network: a sight to behold[J]. Endocr Pathol, 2014, 25(4):362-365. |
| [28] | Lubitz CC, Economopoulos KP, Pawlak AC, et al. Hobnail variant of papillary thyroid carcinoma: an institutional case series and molecular profile[J]. Thyroid, 2014, 24(6):958-965. |
| [29] | Liu Z, Kakudo K, Bai Y, et al. Loss of cellular polarity/cohesiveness in the invasive front of papillary thyroid carcinoma, a novel predictor for lymph node metastasis; possible morphological indicator of epithelial mesenchymal transition[J]. J Clin Pathol, 2011, 64(4):325-329. |
| [30] | Vural C, Kiraz U, Turan G, et al. Solid variant of papillary thyroid carcinoma: an analysis of 28 cases with current literature[J]. Ann Diagn Pathol, 2021, 52:151737. |
| [31] | Ohashi R, Kawahara K, Namimatsu S, et al. Clinicopathological significance of a solid component in papillary thyroid carcinoma[J]. Histopathology, 2017, 70(5):775-781. |
| [32] | Song YS, Won JK, Yoo SK, et al. Comprehensive transcriptomic and genomic profiling of subtypes of follicular variant of papillary thyroid carcinoma[J]. Thyroid, 2018, 28(11):1468-1478. |
| [33] | O′Neill CJ, Vaughan L, Learoyd DL, et al. Management of follicular thyroid carcinoma should be individualised based on degree of capsular and vascular invasion[J]. Eur J Surg Oncol, 2011, 37(2):181-185. |
| [34] | Aschebrook-Kilfoy B, Grogan RH, Ward MH, et al. Follicular thyroid cancer incidence patterns in the United States,1980-2009[J]. Thyroid, 2013, 23(8):1015-1021. |
| [35] | Thompson LDR, Poller DN, Kakudo K, et al. An international interobserver variability reporting of the nuclear scoring criteria to diagnose noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a validation study[J]. Endocr Pathol, 2018, 29(3):242-249. |
| [36] | Jung SH, Kim MS, Jung CK, et al. Mutational burdens and evolutionary ages of thyroid follicular adenoma are comparable to those of follicular carcinoma[J]. Oncotarget, 2016, 7(43):69638-69648. |
| [37] | DeLellis R, LIoyd R, Heitz P, et al. WHO Classification of Tumours: Pathology and Genetics of Tumours of Endocrine Organ[M]. 3rd ed. Lyon:IARC, 2004. |
| [38] | 刘志艳, 周庚寅, Kakudo K, 等. 2017版WHO甲状腺肿瘤分类解读[J]. 中华病理学杂志, 2018, 47(4):302-306. |
| [39] | 刘志艳. 具有乳头样核特征的非浸润性甲状腺滤泡性肿瘤及其诊断标准[J]. 中华病理学杂志, 2017, 46(3):205-208. |
| [40] | Ghossein RA, Hiltzik DH, Carlson DL, et al. Prognostic factors of recurrence in encapsulated hurthle cell carcinoma of the thyroid gland: a clinicopathologic study of 50 cases[J]. Cancer, 2006, 106(8):1669-1676. |
| [41] | Kasaian K, Chindris AM, Wiseman SM, et al. Men 1 mutations in hurthle cell (oncocytic) thyroid carcinoma[J]. J Clin Endocrinol Metab, 2015, 100(4):E611-E615. |
| [42] | Maximo V, Soares P, Lima J, et al. Mitochondrial DNA somatic mutations (point mutations and large deletions) and mitochondrial DNA variants in human thyroid pathology: a study with emphasis on hurthle cell tumors[J]. Am J Pathol, 2002, 160(5):1857-1865. |
| [43] | NCCN Clinical Practice Guidelines in Oncology: Thyroid Carcinoma 2021v2[EB/OL].[2021-09-27].https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf |
| [1] | HE Wen, GU Jianhua, XING Xujian, WENG Ziyi, FEI Jian. Tracheal diverticula discovered during surgery: a report of 2 cases and literature review [J]. Journal of Surgery Concepts & Practice, 2023, 28(04): 383-387. |
| [2] | KONG Weiqi, HE Jun, YANG Chengguang, LIU Weiwei, XU Yingjie. Pheochromocytoma with papillary thyroid carcinoma: one case report [J]. Journal of Surgery Concepts & Practice, 2023, 28(02): 162-165. |
| [3] | YAN Haibo, XIA Zhongping, CHEN Shan, JIANG Lin, HAN Chun. Risk factors for Delphian lymph node metastasis in papillary thyroid carcinoma [J]. Journal of Surgery Concepts & Practice, 2022, 27(05): 453-457. |
| [4] | LI Rui, LIU Zhuoran, YAN Jiqi. Progress of study on medullary thyroid carcinoma with serum calcitonin-negative and large mass [J]. Journal of Surgery Concepts & Practice, 2022, 27(03): 271-275. |
| [5] | CHEN Chengkun, GUO Bomin, DENG Xianzhao, WU Bo, FAN Youben. Diagnosis and treatment of medullary thyroid carcinoma-an update [J]. Journal of Surgery Concepts & Practice, 2022, 27(03): 276-280. |
| [6] | WU Chunxiao, GU Kai, PANG Yi, BAO Pingping, WANG Chunfang, SHI Liang, XIANG Yongmei, GONG Yangming, DOU Jianming, WU Mengyin, FU Chen, SHI Yan. Thyroid cancer incidence and mortality in Shanghai China 2016 and trends from 2002 to 2016 [J]. Journal of Surgery Concepts & Practice, 2022, 27(01): 58-65. |
| [7] | LIU Rongyao, LI Xiangcui, WANG Lina, CHEN Haizhen. Analysis of risk factors for cervical lymph node metastasis in papillary thyroid carcinoma [J]. Journal of Surgery Concepts & Practice, 2022, 27(01): 76-79. |
| [8] | ZHAN Ling, QIU Weihua. Progress in study on apatinib in treatment of both radioactive iodine refractory and more aggressive thyroid carcinoma [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 564-567. |
| [9] | FAN Jinfang, SHEN Yi, ZHAN Weiwei, TAO Lingling, LI Weiwei, KUANG Lijun, ZHOU Wei. Clinicopathological analysis of papillary thyroid microcarcinoma in isthmus [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 528-531. |
| [10] | ZHANG Gang, ZHANG Zhe, ZHANG Shu, LI Zhirong, TIAN Wuguo, HUANG Qi, WANG Lingli, XU Yan. Association between RET genotype and disease phenotype in patients with hereditary medullary thyroid carcinoma [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 522-527. |
| [11] | SUN Hanxing, SHEN Xiaohui, GAO Haoji, LIU Zhuoran, CHEN Xi, QIU Weihua, YAN Jiqi. Preoperative evaluation and preparation of Graves′ disease: a report of 126 cases [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 517-521. |
| [12] | YAN Shouyi, CHEN Hongbin, ZHANG Liyong, WANG Bo, CAI Shaojun, LIN Siying, ZHAO Wenxin. Retrospective study on Bethesda Ⅴ thyroid nodule in diagnosis of papillary thyroid carcinoma: retrospective study [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 512-516. |
| [13] | WANG Zhuoying, SHI Yuan, GUO Kai, QIAN Kai. Making strange new norm: clinical approaches to children andadolescent with differentiated thyroid carcinoma [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 497-499. |
| [14] | HUANG Naisi, CHEN Jiaying, Jl Qinghai, QANG Yu. New adjuvant treatment of locally advanced thyroid carcinoma in era of targeted therapy [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 493-496. |
| [15] | WANG Xudong. Interpretation of more aggressive papillary thyroid microcarcinoma [J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 486-492. |
| Viewed | ||||||
|
Full text |
|
|||||
|
Abstract |
|
|||||
