Abstract
Papillary thyroid cancer (PTC) accounts for 80–90% of all thyroid malignancies. The tall cell variant (TCV) is a rare aggressive histotype of PTC. We performed a meta-analysis to compare the clinicopathological characteristics and prognostic factors of TCV with those of classical papillary thyroid carcinoma (cPTC). A literature search was performed using the PubMed and EMBASE databases using Medical Subject Headings and keywords. Twenty studies that included 1871 patients with TCV and 75323 patients with cPTC were included in our meta-analysis. Odds ratios and confidence intervals were calculated for each study. Patients with TCV were associated with multifocality, higher TNM stage, extrathyroidal extension, vascular invasion, lymph node metastasis, distant metastasis, BRAF mutation, disease-specific survival, and overall survival. We found that TCV cases were associated with more aggressive clinicopathological characteristics and poorer prognoses than cPTC cases were. Our results suggest that TCV is a high-risk PTC that warrants aggressive treatment and follow-up strategies.
Highlights
Papillary thyroid cancer (PTC), whose global incidence has rapidly increased in recent decades, accounts for more than 80% of all thyroid carcinomas, making it the most common type of thyroid malignancy [1, 2]
We found that tall cell variant (TCV) cases were associated with more aggressive clinicopathological characteristics and poorer prognoses than classical papillary thyroid carcinoma (cPTC) cases were
20 studies that included a total of 1871 patients with TCV and 75323 patients with cPTC were selected using the described search strategy [8, 10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28]
Summary
Papillary thyroid cancer (PTC), whose global incidence has rapidly increased in recent decades, accounts for more than 80% of all thyroid carcinomas, making it the most common type of thyroid malignancy [1, 2]. PTC is derived from the follicular epithelium [3] and includes many histological variants such as tall cell, columnar cell, diffuse sclerosing, solid, and hobnail [4, 5]. The tall cell variant (TCV), a rare histological subtype of PTC that was first reported by Hawk et al in 1976 [6], constitutes 5 to 11% of all PTC cases [7]. Kazaure et al found that TCV incidence increased by 158% (0.05 per 100 000 to 0.13 per 100 000) between 2001 and 2008 [8]. TCV is usually defined as a PTC in which 30% or more of tumor cells are twice as long as they are wide; the World Health Organization defines PTC as TCV when the tumor is composed predominantly of cells whose heights are at least 3 times their widths [9]
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