| Objective To analyze the clinical characteristics and biological aggressiveness of different pathological variants of thyroid papillary carcinoma,and to deepen the understanding of different pathological variants of PTC,especially the highly invasive variants,and provide a reference for making treatment plan and follow-up plans.Methods To collect the medical records of 328 patients with papillary thyroid carcinoma(age,sex,tumor size,pathological stage,concomitant thyroid disease,operative method,extrathyroid extention and lymph node metastasis)admitted to the Surgery oncology of Tumor Hospital of Ningxia Medical University from May 2017 to April 2018.By reviewing pathological sections and according to the classification criteria of "Pathology of Endocrine Tumors Update—Other Thyroid Tumors" issued by WHO in 2017,the variants of papillary thyroid carcinoma were classified.The clinicopathological characteristics of different variants were compared,and the differences among different variants were analyzed by statistical software.Results Of 328 cases of PTC,181(55.2%)were papillary thyroid microcarcinoma(PTMC),84(25.6%)were classical papillary thyroid carcinoma(CPTC),23(7.0%)were follicular variant,13(4.0%)were tall cell variant,11(3.4%)were columnar cell variant,11 cases were(3.4%)clear cell variant,3 cases diffuse sclerosing and 3 cases Solid/trabecular variant,2 were papillary thyroid carcinoma with fibromatosis/fascitiis-likestroma,1 case was Hobnail variant,1 case were Warthin like variant and 1 case was Noninvasive follicularthyroid neoplasm with papillary nuclear features(NIFTP).Among them,the extrathyroid extention(ETE)incidence and lymph node metastasis(LNM)of columnar cell variantand tall cell variant were significantly higher than that of classical papillary thyroid carcinoma(all P<0.05);All 3 cases of diffuse sclerosis appeared ETE;All 3 cases of solid/trabecular variant appeared LNM;Only one hobnail variant was found in this study,no LNM and ETE.Compared all highly invasive pathological variants with classical papillary thyroid carcinoma,the incidence of extrathyroid extention and cervical lymph node metastasis were higher than that of CPTC,The difference has statistical significance(all P<0.05).Conclusion The incidence of extrathyroid extention and lymph node metastasis in highly invasive pathological variant of papillary thyroid cancer is higher than that in classical papillary thyroid cancer.The biological aggressiveness of papillary thyroid cancer is stronger and the incidence of related factors with poor prognosis is higher.To identify the pathological variant of papillary thyroid cancer contained in the cancer focus can provide more references for clinicians in making treatment plans and follow-up plans.So that patients get better treatment effect and prognosis. |
