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A 15 year institutional experience of well-differentiated follicular cell-derived thyroid carcinomas; impact of the new 2017 TNM and WHO Classifications of Tumors of Endocrine Organs on the epidemiological trends and pathological characteristics

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Abstract

Purpose

Our study aimed to describe the evolution of the rate of pathological subtypes of well-differentiated follicular-cell derived thyroid carcinomas (DTCs) in the Department of Pathology, Emergency County Hospital Targu-Mures, Romania over a 15 year period and to assess the impact the new 2017 WHO and TNM classifications of thyroid tumors had on our cases.

Methods

The pathological data were retrieved from the original pathological reports. After applying the exclusion criteria the remaining cases were reviewed on a double-headed microscope and reclassified according to the 2017 WHO and TNM staging system. The follow-up data were collected from the Institute of Oncology Cluj-Napoca, Romania.

Results

Our study included 396 cases of DTCs (375 papillary, 11 follicular, and 10 Hürthle cell carcinomas). PTCs revealed a significant increasing trend over the study period, whereas follicular and Hurthle cell carcinomas remain rare; 125/131 of noninvasive encapsulated follicular variant PTC (EFVPTC) were reclassified as noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTPs), resulting in a 33.3% reduction in the number of PTCs. According to 2017 TNM stage-grouping 31% of 271 patients with DTC were downstaged. Follow-up data were available for most of the patients (65.7%, mean period 58.1 months). All patients with noninvasive EFVPTC were disease free at the last clinical assessment.

Conclusions

The increasing rate of PTC was maintained even after exclusion of NIFTP. By applying 2017 TNM criteria, a significant number of DTC cases were downstaged into a more favorable group. Follow-up data highlight the indolent behavior of noninvasive EFVPTCs reclassified as NIFTPs.

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Acknowledgements

The paper has been revised for the English by an independent scientific language editing service (AngloScribe).

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Authors and Affiliations

  1. Department of Histology, George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu-Mureş, 38 Gh. Marinescu Street, 540139, Targu-Mureş, Romania

    Angela Borda, Ancuța-Elena Zahan & Adela Nechifor-Boilă

  2. Department of Pathology, Targu-Mureş Emergency County Hospital, 50 Gh. Marinescu Street, 540136, Targu-Mureş, Romania

    Angela Borda

  3. Department of Nuclear Medicine, “Ion Chiricuţă” Institute of Oncology, 34-36 Republicii Street, Cluj-Napoca, 400015, Romania

    Doina Piciu & Elena Barbuș

  4. Department of Pathology Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France

    Nicole Berger

  5. Department of Pathology, Targu-Mureş County Hospital, 28 December 1/1918 Boulevard, 540061, Targu-Mureş, Romania

    Adela Nechifor-Boilă

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  1. Angela Borda
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Correspondence to Ancuța-Elena Zahan.

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Borda, A., Zahan, AE., Piciu, D. et al. A 15 year institutional experience of well-differentiated follicular cell-derived thyroid carcinomas; impact of the new 2017 TNM and WHO Classifications of Tumors of Endocrine Organs on the epidemiological trends and pathological characteristics. Endocrine 67, 630–642 (2020). https://doi.org/10.1007/s12020-019-02158-7

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