PDF(Pubmed)
Abstract：
UNASSIGNED: Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) contribute to more than 95% of thyroid malignancies. However, synchronous PTC and FTC are less common; it is most commonly discovered incidentally as synchronous malignancies during operation, which adds difficulties to intraoperative decision-making and postoperative treatment. Therefore, we analyzed the clinicopathological characteristics and prognosis of patients with PTC and FTC in our center.
UNASSIGNED: We conducted a search of single PTC, single FTC, and synchronous PTC/FTC patients who received initial surgery treatment at Fudan University Shanghai Cancer Center from 2006 to 2018 and collected paraffin-embedded samples of synchronous patients. Clinicopathological characteristics were collected from the electronic medical record system. Follow-up was performed through telephone contact or medical records. Exome sequencing was performed by ThyroLead panel.
UNASSIGNED: Total of 42 synchronous PTC/FTC patients, 244 single FTC patients, and 2,959 single PTC patients were included. It showed a similarity between the clinicopathological features of synchronous thyroid cancer patients and single PTC patients, with a greater proportion of females, higher probabilities of lymph node metastasis, and higher rate of concurrence of Hashimoto\'s disease. The disease-free survival (DFS) curve indicated a worse prognosis of the synchronous group and single PTC group compared to the single FTC group, who had a propensity for neck lymph node recurrence; however, logistic multivariate regression analysis did not find any factor related to recurrence in the synchronous group. After re-checking pathology, DNA extraction, and quality control, genetic alteration information of 62 samples including primary tumors and metastatic lymph nodes from 35 synchronous cancer patients was displayed. In total, 81 mutations and 1 fusion gene were identified, including mutations related to outcomes and targeted therapy. Besides, some rare mutations in thyroid cancer were found in these patients.
UNASSIGNED: To conclude, synchronous PTC/FTC tend to be incidentally discovered during or after operation, behaving more like single PTC. The prognosis of synchronous patients is worse than that of single FTC patients and supplemental cervical lymph node dissection, total thyroidectomy, and postoperative radioiodine therapy should be taken into consideration after diagnosis. The next-generation sequencing (NGS) showed a unique molecular feature of synchronous patients with some rare mutations.
UNASSIGNED: We conducted a search of single PTC, single FTC, and synchronous PTC/FTC patients who received initial surgery treatment at Fudan University Shanghai Cancer Center from 2006 to 2018 and collected paraffin-embedded samples of synchronous patients. Clinicopathological characteristics were collected from the electronic medical record system. Follow-up was performed through telephone contact or medical records. Exome sequencing was performed by ThyroLead panel.
UNASSIGNED: Total of 42 synchronous PTC/FTC patients, 244 single FTC patients, and 2,959 single PTC patients were included. It showed a similarity between the clinicopathological features of synchronous thyroid cancer patients and single PTC patients, with a greater proportion of females, higher probabilities of lymph node metastasis, and higher rate of concurrence of Hashimoto\'s disease. The disease-free survival (DFS) curve indicated a worse prognosis of the synchronous group and single PTC group compared to the single FTC group, who had a propensity for neck lymph node recurrence; however, logistic multivariate regression analysis did not find any factor related to recurrence in the synchronous group. After re-checking pathology, DNA extraction, and quality control, genetic alteration information of 62 samples including primary tumors and metastatic lymph nodes from 35 synchronous cancer patients was displayed. In total, 81 mutations and 1 fusion gene were identified, including mutations related to outcomes and targeted therapy. Besides, some rare mutations in thyroid cancer were found in these patients.
UNASSIGNED: To conclude, synchronous PTC/FTC tend to be incidentally discovered during or after operation, behaving more like single PTC. The prognosis of synchronous patients is worse than that of single FTC patients and supplemental cervical lymph node dissection, total thyroidectomy, and postoperative radioiodine therapy should be taken into consideration after diagnosis. The next-generation sequencing (NGS) showed a unique molecular feature of synchronous patients with some rare mutations.
摘要：
■甲状腺乳头状癌（PTC）和滤泡性甲状腺癌（FTC）占甲状腺恶性肿瘤的95％以上。然而,同步PTC和FTC不太常见;它是最常见的偶然发现的同步恶性肿瘤在手术期间,这增加了术中决策和术后治疗的困难。因此,我们分析了本中心PTC和FTC患者的临床病理特征和预后。
■我们对单个PTC进行了搜索，单一FTC，和2006年至2018年在复旦大学上海癌症中心接受初次手术治疗的同步PTC/FTC患者，并收集同步患者的石蜡包埋样本。从电子病历系统收集临床病理特征。通过电话联系或病历进行随访。通过ThyroLead面板进行外显子组测序。
■总共42名同步PTC/FTC患者，244名FTC患者，纳入2,959例单发PTC患者。提示同步甲状腺癌患者与单发PTC患者的临床病理特征相似,女性比例更高，淋巴结转移的可能性更高，桥本病并发率较高。无病生存(DFS)曲线提示同步组和单一PTC组较单一FTC组预后差,有颈部淋巴结复发倾向的人；然而，logistic多因素回归分析未发现任何与同步组复发相关的因素.重新检查病理后，DNA提取,和质量控制，显示了来自35名同步癌症患者的62个样本的遗传改变信息，包括原发性肿瘤和转移性淋巴结。总的来说,81个突变和1个融合基因，包括与结果和靶向治疗相关的突变。此外,在这些患者中发现了一些罕见的甲状腺癌突变。
■总而言之，同步PTC/FTC往往是在操作过程中或之后偶然发现的，表现得更像单个PTC。同步患者的预后比单一FTC患者和补充颈淋巴结清扫的患者差，甲状腺全切除术,诊断后应考虑术后放射性碘治疗。下一代测序（NGS）显示了一些罕见突变的同步患者的独特分子特征。
■我们对单个PTC进行了搜索，单一FTC，和2006年至2018年在复旦大学上海癌症中心接受初次手术治疗的同步PTC/FTC患者，并收集同步患者的石蜡包埋样本。从电子病历系统收集临床病理特征。通过电话联系或病历进行随访。通过ThyroLead面板进行外显子组测序。
■总共42名同步PTC/FTC患者，244名FTC患者，纳入2,959例单发PTC患者。提示同步甲状腺癌患者与单发PTC患者的临床病理特征相似,女性比例更高，淋巴结转移的可能性更高，桥本病并发率较高。无病生存(DFS)曲线提示同步组和单一PTC组较单一FTC组预后差,有颈部淋巴结复发倾向的人；然而，logistic多因素回归分析未发现任何与同步组复发相关的因素.重新检查病理后，DNA提取,和质量控制，显示了来自35名同步癌症患者的62个样本的遗传改变信息，包括原发性肿瘤和转移性淋巴结。总的来说,81个突变和1个融合基因，包括与结果和靶向治疗相关的突变。此外,在这些患者中发现了一些罕见的甲状腺癌突变。
■总而言之，同步PTC/FTC往往是在操作过程中或之后偶然发现的，表现得更像单个PTC。同步患者的预后比单一FTC患者和补充颈淋巴结清扫的患者差，甲状腺全切除术,诊断后应考虑术后放射性碘治疗。下一代测序（NGS）显示了一些罕见突变的同步患者的独特分子特征。
