临床与实验病理学杂志2023，Vol.39Issue(12)：1482-1486,1491,6.DOI:10.13315/j.cnki.cjcep.2023.12.014
甲状腺乳头状癌中鳞状细胞成分的鉴别诊断及预后意义
Defferential diagnosis and prognostic significance of squamous cell components in papillary thyroid carcinoma
摘要
Abstract
Purpose To investigate the diagnostic criteria and prognostic significance of squamous cell components in pa-pillary thyroid carcinoma(PTC).Methods Twenty-three cases of PTC containing squamous cell components were collect-ed,and pathological sections were reviewed.p40,CK5/6,Ki-67,BRAF V600E,p53,PD-L1(22C3),PAX8,and CD10,markers related to diagnosis,prognosis,and treatment,were de-tected by immunohistochemistry.Histological characteristics and immunophenotype of squamous cell components were comprehen-sively evaluated.The squamous cell components were classified histologically.The relationship between squamous cell classifica-tion and clinicopathological parameters,and their prognostic im-pact were analyzed.Results The squamous cell components were divided into squamous differentiation(19 cases)and ana-plastic carcinoma(4 cases).In the latter,the squamous cell components were diffusely distributed in sheets;the cell atypia was moderate to severe;and the Ki-67 index was at least 30%.High expression of p53 was found only in anaplastic carcinoma.Compared with squamous differentiation,anaplastic carcinoma had a larger diameter,higher BRAF V600E positive rate,high PD-L1 combined positive score,and extremely worse progression-free survival and overall survival.Squamous differentiation had inconspicuous impact on survival,and only one case relapsed af-ter secondary surgery.Conclusion The cell atypia,distribu-tion,maximum diameter,Ki-67 and p53 expression of squamous cell components are helpful in differentiating squamous compo-nents from anaplastic carcinoma.Positive BRAF V600E and PD-L1 expression suggest the feasibility of targeted therapy and im-munotherapy for anaplastic carcinoma.关键词
甲状腺乳头状癌/鳞状分化/未分化癌/BRAF V600E/PD-L1Key words
papillary thyroid carcinoma/squamous differentia-tion/anaplastic carcinoma/BRAF V600E/PD-L1分类
医药卫生引用本文复制引用
任文浩,黄小征,周立新,白艳花..甲状腺乳头状癌中鳞状细胞成分的鉴别诊断及预后意义[J].临床与实验病理学杂志,2023,39(12):1482-1486,1491,6.基金项目
北京市海淀区卫生健康发展科研培育计划项目(HP2023-31-503003) （HP2023-31-503003）
