Папиллярная карцинома щитовидной железы с ангиоинвазией: обзор литературы

Папиллярный рак щитовидной железы (ПРЩЖ) является наиболее распространенной формой дифференцированного рака щитовидной железы и, как правило, сопровождается индолентным течением. Роль способности к ангиоинвазии и ее влияние на прогноз при ПРЩЖ до сих пор остаются неопределенными. Авторы провели электронный поиск публикаций в базе данных PubMed. При многофакторном анализе в ряде исследований ангиоинвазивность перестает быть самостоятельным фактором неблагоприятного прогноза. Существование противоречивых данных о прогностической роли ангиоинвазивности при ПРЩЖ может объясняться трудностью дифференцировки между инвазией в кровеносные и лимфатические сосуды и использованием разных критериев истинной ангиоинвазии при морфологическом исследовании операционного материала. Данные литературы о прогностической роли протяженности инвазии в кровеносные сосуды при ПРЩЖ ограничены единичными работами и не позволяют сделать выводы о каком-либо пороговом значении для стратификации риска рецидива. При исследовании образований больших размеров особую актуальность приобретает проблема зависимости числа выявленных очагов инвазии от количества исследованных срезов опухоли. Проблема прогностической ценности ангиоинвазивности как фактора риска рецидива и прогрессирования ПРЩЖ и основы для выбора более агрессивной тактики лечения требует дальнейшего исследования.

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