Angela Borda1,2, Ancuța-Elena Zahan3, Doina Piciu4, Elena Barbuș4, Nicole Berger5, Adela Nechifor-Boilă1,6. 1. Department of Histology, George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu-Mureş, 38 Gh. Marinescu Street, 540139, Targu-Mureş, Romania. 2. Department of Pathology, Targu-Mureş Emergency County Hospital, 50 Gh. Marinescu Street, 540136, Targu-Mureş, Romania. 3. Department of Histology, George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu-Mureş, 38 Gh. Marinescu Street, 540139, Targu-Mureş, Romania. ancutazahan@gmail.com. 4. Department of Nuclear Medicine, "Ion Chiricuţă" Institute of Oncology, 34-36 Republicii Street, Cluj-Napoca, 400015, Romania. 5. Department of Pathology Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France. 6. Department of Pathology, Targu-Mureş County Hospital, 28 December 1/1918 Boulevard, 540061, Targu-Mureş, Romania.
Abstract
PURPOSE: Our study aimed to describe the evolution of the rate of pathological subtypes of well-differentiated follicular-cell derived thyroid carcinomas (DTCs) in the Department of Pathology, Emergency County Hospital Targu-Mures, Romania over a 15 year period and to assess the impact the new 2017 WHO and TNM classifications of thyroid tumors had on our cases. METHODS: The pathological data were retrieved from the original pathological reports. After applying the exclusion criteria the remaining cases were reviewed on a double-headed microscope and reclassified according to the 2017 WHO and TNM staging system. The follow-up data were collected from the Institute of Oncology Cluj-Napoca, Romania. RESULTS: Our study included 396 cases of DTCs (375 papillary, 11 follicular, and 10 Hürthle cell carcinomas). PTCs revealed a significant increasing trend over the study period, whereas follicular and Hurthle cell carcinomas remain rare; 125/131 of noninvasive encapsulated follicular variant PTC (EFVPTC) were reclassified as noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs), resulting in a 33.3% reduction in the number of PTCs. According to 2017 TNM stage-grouping 31% of 271 patients with DTC were downstaged. Follow-up data were available for most of the patients (65.7%, mean period 58.1 months). All patients with noninvasive EFVPTC were disease free at the last clinical assessment. CONCLUSIONS: The increasing rate of PTC was maintained even after exclusion of NIFTP. By applying 2017 TNM criteria, a significant number of DTC cases were downstaged into a more favorable group. Follow-up data highlight the indolent behavior of noninvasive EFVPTCs reclassified as NIFTPs.
PURPOSE: Our study aimed to describe the evolution of the rate of pathological subtypes of well-differentiated follicular-cell derived thyroid carcinomas (DTCs) in the Department of Pathology, Emergency County Hospital Targu-Mures, Romania over a 15 year period and to assess the impact the new 2017 WHO and TNM classifications of thyroid tumors had on our cases. METHODS: The pathological data were retrieved from the original pathological reports. After applying the exclusion criteria the remaining cases were reviewed on a double-headed microscope and reclassified according to the 2017 WHO and TNM staging system. The follow-up data were collected from the Institute of Oncology Cluj-Napoca, Romania. RESULTS: Our study included 396 cases of DTCs (375 papillary, 11 follicular, and 10 Hürthle cell carcinomas). PTCs revealed a significant increasing trend over the study period, whereas follicular and Hurthle cell carcinomas remain rare; 125/131 of noninvasive encapsulated follicular variant PTC (EFVPTC) were reclassified as noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs), resulting in a 33.3% reduction in the number of PTCs. According to 2017 TNM stage-grouping 31% of 271 patients with DTC were downstaged. Follow-up data were available for most of the patients (65.7%, mean period 58.1 months). All patients with noninvasive EFVPTC were disease free at the last clinical assessment. CONCLUSIONS: The increasing rate of PTC was maintained even after exclusion of NIFTP. By applying 2017 TNM criteria, a significant number of DTC cases were downstaged into a more favorable group. Follow-up data highlight the indolent behavior of noninvasive EFVPTCs reclassified as NIFTPs.
Entities:
Keywords:
Downstaging; NIFTP; Papillary thyroid carcinoma; Prevalence; TNM-8; WHO 2017
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