具有乳头样核特征的非浸润性甲状腺滤泡性肿瘤诊治进展*

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近年来,具有乳头样核特征的非浸润性甲状腺滤泡性肿瘤(non-invasive follicular thyroid neoplasm with pa-pillary-like nuclear features, NIFTP)逐渐被临床及病理学者重视并加以研究.此种类型的甲状腺肿瘤的细胞核与甲状腺乳头状癌(papillary thyroid carcinoma, PTC)的细胞核特征相似,之前归属为PTC的一个特殊病理亚型,临床处理依据分化性甲状腺癌(differentiated thyroid carcinoma, DTC)诊疗规范进行,但由于该类型肿瘤预后好,很少出现复发和转移,因此有学者建议此种肿瘤应从“癌”重新界定为极低度恶性潜能癌从而避免过度诊断及过度治疗.但如何正确诊断该类型肿瘤并规范处理,国内外仍存在认识不足而出现不平衡现象.鉴于此,本文通过综述NIFTP的最新研究进展,对该肿瘤的临床特征、诊治特点、鉴别及预后情况进行综述性报道,进而为提高临床医生对该肿瘤的重视程度及诊治能力提供参考证据.“,”The non-invasive follicular thyroid neoplasm with papillary-like nuclear features ( NIFTP) is a rare primary thyroid tumor which has drawn more and more attention by clinicians and pathologists in recent years. This variant of thy-roid tumor harbors the nuclear features of papillary thyroid carcinoma (PTC) and previously belonged to a special pathologi-cal subtype of PTC. The therapeutic strategy is implemented in accordance with the treatment and diagnosis guideline of dif-ferentiated thyroid carcinoma. However, due to its good prognosis and low recurrence rate, some scholars suggest that this kind of tumor should be redefined as a very low-grade malignant potential tumor, so as to avoid overdiagnosis and overtreat-ment. It is still unclear on how to correctly diagnose this type of tumor and how to deal with it in a standardized way. In this setting, this paper reviews the latest research in the clinical characteristics, diagnosis, differential diagnosis, treatment and prognosis of NIFTP, thus providing better references for thyroid tumor-related clinical doctors.
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杨新中是湖北中医学院教授、硕士生导师,长期从事中西医疗法治疗肿瘤临床研究,经验丰富.
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