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各种不同组织学类型甲状腺癌因其生物学行为的不同,在预后及治疗反应上存在着明显差异。所以,在选择甲状腺癌的治疗方针与方法时,需要得到病理医师的帮助,搞清楚癌的组织学类型。甲状腺癌的组织学类型分为滤泡起源的乳头状癌、滤泡状癌与未分化癌及滤泡旁细胞(C细胞)起源的髓样癌。这一分类首先由Woolner等(1961)和Hazard(1964)提出,受到临床的重视,现已被世界卫生组织甲状腺肿瘤组织学分类咨询中心采纳。乳头状癌约占成人甲状腺癌的50%,儿童甲状腺癌的80%。瘤组织由乳头状结构与多少不一的滤泡构成。瘤细胞核常呈所谓毛玻璃样。有人指出,甲状腺癌凡有毛玻璃样细胞核者,即使仅由滤泡构成,亦应归属乳头状癌。滤泡状癌占甲状腺癌的25%,瘤组织由大小不一的滤泡或夹杂实心束状团状成分组成,细胞核染色质多而致密。高分化者有时难以和正常甲状腺组
Different types of histological types of thyroid cancer have significant differences in their prognosis and response to treatment due to their different biological behaviors. Therefore, in the selection of thyroid cancer treatment guidelines and methods, you need to get the help of pathologists to figure out the histological type of cancer. The histological types of thyroid cancer are divided into papillary carcinoma of follicular origin, medullary carcinoma of follicular and undifferentiated carcinoma, and parafollicular (C) cell origin. This classification was first proposed by Woolner et al. (1961) and Hazard (1964). It has received clinical attention and has now been adopted by the World Health Organization Thyroid Tumor Histology Classification Consultation Center. Papillary cancer accounts for about 50% of adult thyroid cancer and 80% of children’s thyroid cancer. The tumor tissue consists of a papillary structure and a number of different follicles. Tumor cell nuclei often have so-called ground glass. It has been pointed out that thyroid cancer, where there is a vitreous-like cell nucleus, even if it consists only of follicles, should also belong to papillary carcinoma. Follicular carcinoma accounts for 25% of thyroid cancer. The tumor tissue consists of different sizes of follicles or solid bundle-like components with dense nuclear chromatin. Hyperdifferentiators are sometimes difficult and normal thyroid