Clinical and biological characteristics and the diagnosis and management of poorly-differentiated thyroid carcinoma / 肿瘤

ABSTRACT

Objective: To investigate the clinical and biological characteristics of PDTC (poorly-differentiated thyroid carcinoma) and the appropriate diagnosis and management. Methods: The clinical records of 35 hospitalized patients with PDTC (poorly-differentiated thyroid carcinoma) admitted between January 2007 and December 2011 were collected and retrospectively analyzed. The followed-up was conducted. Meanwhile, 1 485 hospitalized patients with DTC (differentiated thyroid carcinoma) were also collected as the controls. The clinical and biological characteristics between 35 PDTC patients and 1 485 DTC patients were compared. Results: The primary tumor size (P = 0.005), blood vessel invasion (P = 0.001), clinical TNM staging (P = 0.002) and recurrence (P = 0.007) were significantly different between 35 PDTC patients and 1 485 DTC patients. Of 12 PDTC patients with vessel invasion, 4 had intravascular tumor thrombi, 2 had lung metastasis, 1 had liver and bone metastases. The age, gender, multifocality, esophageal invasion, recurrent laryngeal nerve invasion, lymphatic metastasis and serum thyroid stimulating hormone level were not significantly different between 35 PDTC patients and 1 485 DTC patients (P > 0.05). Conclusion: PDTC is a highly malignant form of thyroid carcinoma which usually presents at advanced T stage and TNM stage, with high rates of blood vessel invasion, recurrence and distant metastasis. Diagnostic accuracy can be improved via preoperative fine needle aspiration of thyroid and pathology as well as clinical TNM staging and risk evaluation guided by ultrasonography. Furthermore, personalized, functional and multidisciplinary therapeutic strategies should be performed to improve the prognosis of patients with PDTC. Copyright © 2013 by TUMOR.