The clinicopathological characteristics and prognosis of 269 cases of medullary thyroid carcinoma
WANG Hongqun
LI Jie
LIU Peng
MA Yaqi
MA Zhihou
GONG Youjie
ZHANG Yangyang
SHI Huaiyin
Abstract：Objective To explore the clinicopathological characteristics of medullary thyroid carcinoma(MTC)and analyze the factors affecting prognosis.Methods The clinicopathologic data and follow-up outcome of 269 cases of MTC were retrospectively analyzed.Results In patients with MTC,males accounted for 49.8%.62.9%of MTC patients had lymph node(LN)metastasis.Tumors with≥2 foci accounted for 35.8%.Tumors with a diameter≦2 cm accounted for 67.3%.Patients aged 41-50 years old accounted for 27.1%.The distant metastasis rate was 7.4%.The overall mortality rate during the follow-up period was 9.6%.The recurrence rate after surgery/treatment was 14.8%.Immunohistochemistry showed positive for TTF-1(99.0%+),Calcitonin(85.4%+),Syn(98.7%+),CgA(81.9%+),and CEA(88.8%+).The positive rate of Ki-67 was 95.1%with a positivity≤10%.Patients with late staging,larger maximum diameter,capsular invasion,tumor thrombus,recurrence cancer,as well as those with MEN2/family history were more likely to develop multiple lesions,and those with multiple lesions were more prone to postoperative recurrence(all P<0.05).The overall survival(OS)rate at 5,10,and 14 years were(90.0±0.03)%,(80.0±0.05)%,and(80.0±0.05)%,respectively.Univariate survival analysis showed that lymph node metastasis,older age,late TNM staging,degree of capsular invasion,intravascular tumor thrombus,distant metastasis(DM),and postoperative/post-treatment recurrence and metastasis were associated with OS.Multivariate Cox survival analysis showed that DM,lymph node metastasis,and capsular invasion were associated with relapse-free survival(RFS).The OS rate of MTC was second only to the papillary thyroid carcinoma group.Conclusions Distant metastases,age,and tumor thrombosis are independent prognostic factors affecting MTC,and MTC has a better prognosis.
Keywords：Medullary thyroid carcinomaClinicopathological featuresPrognosisLymph node metastasisNumber of MTC foci
Publication Date：2025-07-28
Online Publishing Date：2025-08-27(First online date of this platform, not the publication date of the document)
Pages：9( 829-837 )