Is new American Thyroid Association risk classification for hereditary medullary thyroid carcinoma applicable to Chinese patients? A single-center study
| Autor: | Wensheng Liu, Yong-xia Zhang, Yuqin He, Dangui Yan, Xiwei Zhang, Bin Zhang, Hanfeng Wan, Yabing Zhang, Junyi Wang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Oncology rearranged during transfection (RET) Cancer Research medicine.medical_specialty genotype-phenotype correlation Single Center Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Medical history Stage (cooking) Medullary thyroid carcinoma (MTC) business.industry multiple endocrine neoplasia type 2 (MEN2) RET Gene Mutation Thyroid Cancer medicine.disease 030104 developmental biology medicine.anatomical_structure Hypoparathyroidism prophylactic thyroidectomy 030220 oncology & carcinogenesis Original Article business |
| Zdroj: | Chinese Journal of Cancer Research |
| ISSN: | 1000-9604 |
| DOI: | 10.21147/j.issn.1000-9604.2017.03.08 |
| Popis: | Objective The American Thyroid Association (ATA) proposed a new risk classification for hereditary medullary thyroid carcinoma (MTC) in 2015. This study aimed to assess whether the new guidelines are suitable for the Chinese population, and reported our experience on prophylactic thyroidectomy. Methods A total of 73 patients from 22 families were screened as rearranged during transfection (RET) mutation carriers from 2010 to 2016 in Cancer Hospital, Chinese Academy of Medical Science; the medical history for each patient was collected. Based on the initial treatment, we identified the risk factors for poor prognosis by univariate and multivariate logistic regression. Then, 4 RET mutation carriers were enrolled for prophylactic thyroidectomy, and their pathological data and follow-up outcomes were recorded. Results In univariate and multivariate logistic regression analyses, age at initial surgery and risk classification were significant risk factors for stage III/IV hereditary MTC at initial diagnosis. The likelihood was increased by 11.6% per year of age at initial surgery [95% confidence interval (95% CI), 1.040–1.198; P=0.002). It was 7.888 times more likely to have III/IV stage disease for ATA highest risk patients, compared to ATA moderate risk individuals (95% CI, 1.607–38.717; P=0.003). Postoperative pathological results showed all 4 multiple endocrine neoplasia type 2A (MEN2A) patients had C-cell hyperplasia (CCH); multifocal malignancies were detected in 3 of them. All 4 patients were cured biochemically, and none developed permanent hypoparathyroidism. Conclusions In Chinese individuals, hereditary MTC aggressiveness is in line with the new ATA risk classification. Germline RET gene mutation carriers should undergo prophylactic thyroidectomy according to basal serum calcitonin levels. |
| Databáze: | OpenAIRE |
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