甲状腺与乳腺多原发肿瘤的临床特征分析  

Analysis of the clinical characters of multiple primary tumors of thyroid and breast

作　　者：运新伟[1] 高明[1] 

机构地区：[1]天津医科大学附属肿瘤医院甲状腺颈部肿瘤科,天津市肿瘤防治重点实验室,300060

出　　处：《中华内分泌外科杂志》2012年第1期28-31,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的分析甲状腺与乳腺多原发肿瘤的临床特征对病程产生的不同影响。方法收集天津医科大学附属肿瘤医院1978年1月至2004年12月收治的甲状腺与乳腺多原发肿瘤（包括良、恶性）235例进行分析，先证肿瘤为乳腺肿瘤144例（A组），先证甲状腺肿瘤91例（B组），筛选出相关危险因素；以保存有完整组织蜡块的甲状腺与乳腺多原发癌27例（C组）为研究对象，并设置对照组（甲状腺癌及乳腺癌各25例），用免疫组化检测ER、PR在甲状腺癌及其并发的乳腺癌中的表达，探讨其差异及相关性。结果发病间隔时间与后发肿瘤的良恶性关系有统计学意义（A组t=-2．102，P=0．047；B组t=-3．044，P=0．003）；〉50岁的A组患者及〉40岁的B组患者其发病间隔时间明显缩短（A组t=3．738，P=0．000；B组t=2．472，P=0．018）；C组中的甲状腺癌及乳腺癌ER免疫组化表达呈正相关（rs=0．516，P=0．006）；C组与对照组甲状腺癌ER强表达率差异有统计学意义（x2=4．638，P=0．031）。结论〉40岁的甲状腺肿瘤患者或〉50岁的乳腺肿瘤患者患良性第二原发肿瘤的可能性较大，间隔时间越长，则并发对应部位恶性肿瘤的可能性更大。甲状腺与乳腺多原发癌患者的甲状腺及乳腺癌组织的ER表达水平具有相关性，甲状腺癌组织ER强表达率较一般人群高，这为甲状腺与乳腺多原发癌的内分泌治疗提供了依据。Objective To analyze the clinical characters of multiple primary tumors of thyroid and breast. Methods A total of 235 cases [ 144 cases were firstly diagnosed as breast carcinoma （group A） and 91 cases were firstly diagnosed as thyroid carcinoma （ group B） ] of multiple primary tumors （ including benign and malignant） of thyroid and breast admitted from Jan. 1978 to Dec. 2004 in Tianjin Medical University Cancer Institute and Hospital were analyzed. The related risk factors were selected. 27 cases （ group C） of multiple primary cancers of thyroid and breast were included and the control groups （ thyroid cancers and breast cancers ： 25 cases for each group） were set up. hnmunohistochemical method was used to detect the expression of ER and PR in thyroid carcinoma complicated with breast cancer. The difference and relevance were explored. Results The interval had great effects on the nature （benign or malignant） of the second primary tumor （group A： t = -2. 102, P = 0. 047 ; group B ： t = - 3. 044, P = 0. 003 ）. The interval decreased significantly in patients older than 50 years in A group and older than 40 years in B group （ group A ： t = 3. 738, P = 0.000 ; group B ： t = 2. 472, P = 0.018）. There was positive correlation between thyroid and the breast carcinoma in ER immunohistochemical ex- pression in group C （rs =0.516, P =0.006）. The difference of ER strong expression in thyroid carcinoma had statistical significance between group C and the control group （x2 = 4. 638, P = 0. 031 ）. Conclusions Patients of thyroid carcinoma older than 40 years and patients of breast carcinoma older than 50 years are very likely to get the second primary benign tumor, but if the reciprocal tumor occurred after a long time, it is more likely to be malignant. ER expression level has positive correlation between thyroid and breast carcinoma tissues in patients with multiple thyroid and breast carcinomas, and ER strong expression rate is higher in patients with thyroid carcinomas th

关 键 词：甲状腺癌 乳腺癌 多原发瘤 临床特征 雌激素受体 

分 类 号：R737.9[医药卫生—肿瘤]