強子顯示向濾泡上皮分化證據(jù)、并以顯著核特征性為特

1甲狀 狀 — —Sternberg'sDiagnosticSurgical2Withincreasingexperience,itbecameevidentthatthecellsofpapillarycarcinomahavecharacteristicnuclearfeatures.Thesehaveacquiredsomuchrelevancethatcurrentlythediagnosisofpapillarycarcinomaismoredependentupontheirpresencethanonthepapillaryarchitecture,whichmaybeminororaltogetherabsentRosaiandAckerman'sSurgical34Papillarycarcinomaisawell-differentiatedmalignanttumorofthyroidfollicularcellsthatshowsasetofcharacteristicnuclearfeatures.Althoughapapillarygrowthpatternisfrequentlyseen,itisnotrequiredforthe4DiagnosticPathologyandMolecularGeneticsofthe關(guān)鍵在于核的特征性甲狀 狀癌的特結(jié)細砂礫其5結(jié) Papillarythyroidlesionsincludepapillarycarcinoma,papillaryhyperplasia(oftenassociatedwithhyperfunction),andpapillarychangeinanadenomaoradenomatousfollicularnodule.-Sternberg'sDiagnosticSurgical6788EndocrPract.9核特征增擁核輪廓不規(guī)則、核膜核內(nèi)假包核毛玻璃核 不分先后核輪廓不規(guī)則、核膜增核內(nèi)假包涵大小標內(nèi)容標位置標Pathology12010 核砂礫Human

核特征出現(xiàn)的頻率和特異大部分PTC中，出現(xiàn)幾乎所有的核特征部分PTC出現(xiàn)幾條才足以診斷？無定論。4不分先后？核增大、輪廓不規(guī)則、濾泡上皮+核特征經(jīng) 狀癌的診斷很少遇特征性不明顯 狀病變，診斷重復(fù)性部分罕見亞型，認識Thetypicalnuclearfeaturesmaybe(multi)focalbutifonlyminorchangesareseeninanon-invasivefolliculararch,tumor,somecallit“folliculartumorofuncertainmalignantpotential”.—DiagnosticCriteriaHandbookin您的意AmJClinPathol，08Endocr 您的意見ArchPatholLab您的意見Pathol，09

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在PTC中的比5- 狀癌伴筋膜炎樣間質(zhì)HEADNECKSURG， Papillary “papillarymicrotumor”2004-WHO：不大于1cm+（因其他原因手術(shù)后）PapillaryIntJSurg>20 臨床檢查、頸部超聲或術(shù)前評估未見明顯轉(zhuǎn)Papillary 外、28%有淋轉(zhuǎn)移、0.7%有遠處轉(zhuǎn)移，5%復(fù)發(fā)，DiagnosticPathologyandMolecularGeneticsofthe 疑該如何定義偶該如何嚴格的定義該如何看待mPTC免疫組化及分子生物學(xué)方面有無指導(dǎo)意義臨床該如何準確的處理 非腫瘤區(qū)有無橋本甲狀腺炎、Graves結(jié)構(gòu)：生長模式、細胞高柱狀、實性 JKoreanMedSci5014 Human 或非包裹性mPTC中顯著高于包裹性mPTC。Todate,theWHOclassificationforpapillarythyroidcancerdoesnotdifferentiatebetweenencapsulated,partiallyandnotencapsulatedentities.WethereforesuggestthattheWHOclassificationshouldbeextendedtoacompulsoryoftheencapsulationstatusin HormMetabHuman Mod 上：有纖維化；下：無纖維

纖維化的包膜不算 組織形態(tài)問MultifocalityisnotuniquetoclassicalmPTCandoccursmoreofteninmFVPTC.TheriskoflymphnodemetastasesisgreaterformPTCthan JournalofSurgicalResearch，214Human Human 其他指術(shù)前見 及遠處轉(zhuǎn)移（ClinicalNuclearTSH（無顯著意義WorldJ：兒童（放療史）、45 （Thyroid，2014體重指數(shù)：有意義！尤其對于45歲以下患者來說是否偶見：有意義術(shù)前甲狀腺功能（EndocrRes，2014）：與術(shù)后是否發(fā)生甲減術(shù)后是否行I131Endocrin2014JClinEndocrinolMeta2013AmJ

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Mod 調(diào)、157 JournalofCancerResearchandTherapeutics評分系sex(female=0,multifocality(absent=0,lymphnodemetastasis(absent=0,EurJEndocrinl2012總mPTC總體來 性邊界、腺內(nèi)播散或多灶性、腺 、 轉(zhuǎn)移對于具 的病例，應(yīng)適當擴大手術(shù)范至少單側(cè)腺葉切除思在大部分研究都無WHO對mPTC的觀點密切聯(lián)系臨床！不誤導(dǎo) 可以通過注釋的方Nonewriskfactors,butone,cancomple explainthesurgeof[smallpapillarycancer]lesions:theexponentialincreaseinthe