OBJECTIVE The present study investigated the prognostic factors for follicular thyroid carcinoma (FTC) with the incorporation of the histologic subtype and degree of vascular invasion (VI). PATIENTS The records of 474 patients with FTC confirmed by surgical specimens at Ito Hospital from January 2005 to December 2014 were reviewed in this retrospective cohort study. The Cox proportional hazard model was used to determine factors associated with disease-free survival (DFS) and distant metastasis-free survival. RESULTS Of the 474 patients, 140 (30%) had minimally invasive follicular thyroid carcinoma (MI-FTC), 260 (55%) had encapsulated angio-invasive follicular thyroid carcinoma (EA-FTC), and 74 (16%) had widely invasive follicular thyroid carcinoma (WI-FTC). Among the 428 patients with M0 FTC, the 10-year DFS rates of patients with MI-FTC (n = 133), EA-FTC (n = 247), and WI-FTC (n = 48) were 97.3%, 84.2%, and 69.9% (p < 0.001), respectively. A multivariate analysis identified age ≥ 55 years (hazard ration [HR], 2.204; 95% confidence interval [CI], 1.223-3.969; p = 0.009), histologic subtype (HR, 2.068; 95% CI, 1.064-4.021, p = 0.032), number VI of ≥ 2 (HR, 6.814; 95% CI, 3.157-14.710, p < 0.001), and tumor size > 40 mm (HR, 2.014; 95% CI, 1.089-3.727, p = 0.026) as independent negative prognostic factors for DFS. CONCLUSIONS Our study results may enable us to stratify the prognosis of FTC more accurately by combining the histologic subtype with the degree of VI ≥ 2, age ≥ 55 years, and tumor size > 40 mm.

中文翻译：

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血管侵犯程度在预测滤泡性甲状腺癌预后中的作用。

目的本研究结合组织学亚型和血管侵犯程度（VI），探讨滤泡性甲状腺癌（FTC）的预后因素。患者 本回顾性队列研究回顾了 2005 年 1 月至 2014 年 12 月伊藤医院通过手术标本证实的 474 例 FTC 患者的记录。Cox比例风险模型用于确定与无病生存（DFS）和无远处转移生存相关的因素。结果 474 例患者中，140 例（30%）为微浸润滤泡性甲状腺癌（MI-FTC），260 例（55%）为包膜性血管浸润性滤泡性甲状腺癌（EA-FTC），74 例（16%）为广泛性浸润性滤泡性甲状腺癌。浸润性滤泡性甲状腺癌（WI-FTC）。428例M0 FTC患者中，MI-FTC（n = 133）、EA-FTC（n = 247）和WI-FTC（n = 48）患者的10年DFS率分别为97.3%、84.2%和 69.9% (p < 0.001)。多变量分析确定年龄 ≥ 55 岁（风险比 [HR]，2.204；95% 置信区间 [CI]，1.223-3.969；p = 0.009）、组织学亚型（HR，2.068；95% CI，1.064-4.021，p = 0.032），VI 数≥ 2（HR，6.814；95% CI，3.157-14.710，p < 0.001），且肿瘤大小 > 40 mm（HR，2.014；95% CI，1.089-3.727，p = 0.026）作为 DFS 的独立负面预后因素。结论 我们的研究结果可以使我们结合组织学亚型与 VI ≥ 2 程度、年龄 ≥ 55 岁和肿瘤大小 > 40 mm 更准确地对 FTC 预后进行分层。