桥本甲状腺炎合并甲状腺癌98例诊治  

Hashimoto＇s thyroiditis accompanying with thyroid cancer： 98 cases

作　　者：徐胜前[1] 宋智明[1] 朱国华[1] 

机构地区：[1]江苏省原子医学研究所附属江原医院,江苏214063

出　　处：《中华内分泌外科杂志》2010年第6期388-389,393,共3页Chinese Journal of Endocrine Surgery

摘　　要：目的 探讨桥本甲状腺炎合并甲状腺癌的诊治特点.方法 回顾性分析98例桥本甲状腺炎合并甲状腺癌的临床资料.结果 行甲状腺一侧腺叶切除＋峡部切除2例;行甲状腺双叶切除58例;行中央区淋巴结清扫35例,淋巴结阳性15例;行颈部淋巴结改良根治术3例,淋巴结阳性3例.原发灶直径≤1.0 cm和＞1 cm,中央区淋巴结转移率分别为25.0%和52.2%,差异无统计学意义.结论 桥本甲状腺炎常合并甲状腺乳头状癌,即使为微小癌,也常伴有颈部淋巴结转移.随着肿瘤直径的增大,淋巴结转移亦相应增多.桥本甲状腺炎合并甲状腺癌手术中,应行甲状腺双叶切除,必要时加行中央区及颈侧区淋巴结的清扫.Objective To discuss the clinical characteristics of Hashimoto＇s thyroiditis accompanying with thyroid cancer. Methods Clinical data of 98 cases Hashimoto＇s thyroiditis accompanying with thyroid cancer were retrospectively reviewed. Results 2 cases underwent lateral thyroid lobectomy and isthmus resection. 58 cases underwent bilateral thyroid lobectomy. 35 cases underwent central lymph node dissection, with 15 cases of lymph node positive. 3 cases underwent modified radical dissection of cervical lymph nodes and all of them were proved to be lymph node positive. Metastasis rate is 25.0% and 52. 2% respectively for tumors whose diameter was less than 1 cm and greater than 1 cm. The difference has no statistic significance. Conclusions Hashimoto＇s thyroiditis usually accompany with thyroid papillary carcinoma and cervical lymph node metastasis can occur even if it＇s microcarcinoma. Lymph node metastasis rate increases with increasement of the tumor＇s diameter. Total thyroidectomy should be performed for Hashimoto＇s thyroiditis concomitant with thyroid cancer. And if necessary,lymph node dissection should be extended to the central region and lateral neck area.

关 键 词：桥本甲状腺炎 甲状腺癌 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]