甲状腺乳头状癌合并桥本病的超声及临床病理特征  

Ultrasound features and clinicopathological characteristics of papillary thyroid carcinoma with Hashimoto’s thyroiditis

作　　者：叶昀亮 项颖颖[1] 郑华敏[2] 程溥[1] 张筱骅[1] 

机构地区：[1]温州医科大学附属第一医院肿瘤外科,浙江温州325000 [2]温州医科大学附属第一医院超声诊断科,浙江温州325000

出　　处：《温州医学院学报》2013年第12期771-774,共4页Journal of Wenzhou Medical College

基　　金：国家高技术研究发展计划(863计划)资助项目(2012 AA02A210)

摘　　要：目的 :探讨甲状腺乳头状癌(PTC)合并桥本病(HT)的术前超声及临床病理特征。方法:回顾性分析我院2010年7月至2012年10月经手术病理证实为PTC的患者1 090例。根据术后病理结果分为PTC合并HT组(PTC-HT组)和单纯PTC组(PTC组),比较两组术前超声及临床病理特征。结果:单因素分析结果显示PTC-HT组患者较PTC组年龄更轻,女性患者更多见,术前促甲状腺激素(TSH)水平、甲状腺癌多灶性发生率及肿块边界不清发生率更高(P<0.05)。Logistic回归分析显示患者的年龄、性别、甲状腺癌多灶性、TSH水平是PTC合并HT的独立预测因素(P<0.05)。结论:合并HT的PTC患者较单纯PTC更常见于年龄较轻的女性,B超肿块边界不清发生率、术前TSH水平和甲状腺癌多发灶的发生率更高,手术方式更倾向于选择甲状腺全切术。但肿块边界不清并不是PTC合并HT的独立预测因素,故对于HT合并甲状腺结节的患者,超声医师在关于结节恶性风险的评估和诊断方面无需作出特殊的改变。Objective： To explore the preoperative ultrasound and clinicopathological characteristics of the papillary thyroid carcinoma （PTC） with Hashimoto thyroiditis （HT）. Methods： 1 090 consecutive PTC patients undergone thyroidectomy from July 2010 to October 2012 in our hospital were reviewed.According to whether the postoperative pathology was associated with the HT, the patients were divided into PTC with HT group （PTC-HT group） and PTC without HT group （PTC group）, and the preoperative ultrasound features and clinicopathological characteristics were compared between two groups. Results： The univariate analysis showed patients with HT were younger with a female predominance and present a higher TSH level, higher frequence of multifocality and ill-defined border when compared to PTC patients without lit （P〈0.05）. The logistic regression analysis showed two groups had significant differences in age, gender, thyroid carcinoma muitifocal, TSH level （P 〈0.05）. Conclusion： Compared to PTC patients without HT, patients with HT are younger with a female predominance and present more frequent incidence of ill-defined border, higher TSH level, higher frequence of multifocality which implied total thyroidectomy might be the best choice to these patients with HT. But ill-defined border is not an independent factor to PTC patients with HT, so there is no special change in assessment and diagnosis of nodular malignant risk when according to these patients.

关 键 词：甲状腺肿瘤 桥本病 超声检查 病理学 临床 

分 类 号：R739.91[医药卫生—肿瘤]