Abstract:
:The term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently proposed to replace noninvasive follicular variant of papillary thyroid carcinoma (FVPTC) both to promote more conservative management of these tumors and spare patients the psychological burden of a cancer diagnosis. This reclassification will lower the incidence of papillary thyroid carcinoma (PTC). In addition, it could result in an increase in the rates of unfavorable histologic prognosticators for PTC overall because NIFTPs had previously accounted for many of the PTCs without these features. Our aim was to evaluate the potential impact of the reclassification of NIFTP on the rates of extrathyroidal extension, lymphovascular invasion, and lymph node metastases in PTC. We identified all PTCs clinically over 1 cm diagnosed on surgical resection between August 2010 and August 2012. The histopathologic characteristics, including PTC subtype, tumor size, presence of extrathyroidal extension and lymphovascular invasion, and surgical margin and lymph node status were all recorded. Based on these parameters, cases were classified according to the American Thyroid Association (ATA) risk stratification system for structural disease recurrence. Tumor slides for cases initially diagnosed as FVPTC were reviewed to identify tumors that would now be classified as NIFTPs. Our cohort included 348 cases of PTC, of which 94 (27%) would now be classified as NIFTPs. After excluding NIFTPs from the PTC category, there were increased rates of extrathyroidal extension (26% up from 19%, p = 0.046), lymphovascular invasion (37% up from 27%, p = 0.0099), and lymph node metastases (26% up from 19%, p = 0.045) among the remaining PTCs. Based on these changes in histologic features, 10% fewer cases were defined as ATA low risk (62% down from 72%, p = 0.0081). Our results indicate that the downgrading of some carcinomas to NIFTP will increase the rates of higher risk histologic parameters in the remaining PTCs by statistically significant margins. Although the overall survival for PTC is very high and would likely not be changed significantly by the introduction of NIFTP, additional studies evaluating the impact of the NIFTP shift are warranted.
journal_name
Endocr Patholjournal_title
Endocrine pathologyauthors
Wong KS,Strickland KC,Angell TE,Nehs MA,Alexander EK,Cibas ES,Krane JF,Howitt BE,Barletta JAdoi
10.1007/s12022-017-9476-5subject
Has Abstractpub_date
2017-06-01 00:00:00pages
171-176issue
2eissn
1046-3976issn
1559-0097pii
10.1007/s12022-017-9476-5journal_volume
28pub_type
杂志文章abstract::Breast carcinomas often metastasize into various organs, most commonly into the lung and rather infrequently into the pineal gland. There were only 20 cases of the latter recorded until 1950. Currently, the total number of reported cases, including this report, is 74. At Sunnybrook Health Science Centre, between 1984 ...
journal_title:Endocrine pathology
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journal_title:Endocrine pathology
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doi:10.1007/BF02921487
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journal_title:Endocrine pathology
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journal_title:Endocrine pathology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Endocrine pathology
pub_type: 杂志文章
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journal_title:Endocrine pathology
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journal_title:Endocrine pathology
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journal_title:Endocrine pathology
pub_type: 杂志文章
doi:10.1007/BF02739828
更新日期:1999-06-01 00:00:00
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journal_title:Endocrine pathology
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更新日期:2007-07-01 00:00:00
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