J Korean Med Sci.  2011 Mar;26(3):346-351. 10.3346/jkms.2011.26.3.346.

Tumor Margin Histology Predicts Tumor Aggressiveness in Papillary Thyroid Carcinoma: A Study of 514 Consecutive Patients

• Kim KJ
• Hong SW
• Lee YS
• Kim BW
• Lee SC
• Chang HS
• Park CS

• KMID: 2157870
• DOI: http://doi.org/10.3346/jkms.2011.26.3.346

Abstract

Histologic patterns at tumor margins may be related to prognosis in several malignancies. We investigated tumor aggressiveness with respect to tumor margin histology in patients with papillary thyroid carcinoma (PTC). Five hundred fourteen consecutive patients who underwent surgery for primary PTC between January and July 2009 were assigned to two groups, one with an infiltrative pattern (I-type, n = 347) at tumor margins and one with an expanding pattern (E-type, n = 167). Tumor aggressiveness was assessed by analyzing relationships between these patterns and known prognostic factors. The analysis showed that unfavorable prognostic factors such as tumor multiplicity (P = 0.002), extrathyroidal extension (P < 0.001), lateral neck lymph node metastasis (P < 0.001) and advanced TNM stage (P = 0.001) were significantly more prevalent in patients with I-type PTC than in those with the E-type. Central neck node metastases were more prevalent without statistical significance in the I-type patients (P = 0.376). Tumor margin histology was not related to gender or tumor size. These results suggest that histologic patterns at tumor margins predict aggressiveness in PTC.

Keyword

Carcinoma, Papillary; Thyroid; Margin; Histology; Aggressiveness

MeSH Terms

Adult
Cell Proliferation
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Prognosis
Thyroid Neoplasms/epidemiology/*pathology

Figure

• 

  Fig. 1 Papillary thyroid carcinoma (PTC) with expanding margins (E-type). (A, C, D) PTCs show pushing growth pattern (arrows). No infiltrative portions are identified. (B) Magnification of the squared portion in A (H&E, Magnifications: A and C, × 40; B and D, × 100).

• 

  Fig. 2 Papillary thyroid carcinomas (PTC) with infiltrative margins (I-type). (A, B) PTC with extrathyroidal extension (arrowhead). Infiltrative growths into surrounding normal parenchyma are identified (arrows). (C, D) PTC show diffuse, infiltrative margin between tumor and normal parenchyma (arrows). (H&E, Magnifications: A and C, × 40; B and D, × 100).

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