乳头状甲状腺癌合并桥本甲状腺炎患者临床特点分析  

Clinical characteristics analysis of papillary thyroid carcinoma in patients with Hashimoto's thyroiditis

作　　者：白建平[1] 卢建跃[1] 孙新增[1] 张霆[1] 

机构地区：[1]中国人民解放军第二五四医院普通外科,天津300142

出　　处：《中国医学前沿杂志（电子版）》2015年第5期61-63,共3页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析乳头状甲状腺癌合并桥本甲状腺炎(Hashimoto's thyroiditis,HT)的临床特点,为疾病防治提供参考。方法 2006年2月至2011年2月于本院接受甲状腺肿物切除手术治疗的患者418例,选取其中接受诊治的乳头状甲状腺癌患者63例作为研究对象,其中合并HT的31例患者作为试验组,单纯乳头状甲状腺癌的32例患者作为对照组,分析有无HT患者乳头状甲状腺癌的发病率、两组患者甲状腺功能、影像及病理学改变特点。结果合并HT的患者乳头状甲状腺癌发病率为29.0%(31/107),未合并HT的患者乳头状甲状腺癌发病率为10.3%(32/311);试验组患者血清游离三碘甲状腺原氨酸(FT3)、抗甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)升高率分别为3.2%(1/31)、64.5%(20/31)和71.0%(22/31),对照组分别为9.4%(3/32)、34.4%(11/32)和37.5%(12/32);试验组患者具有低回声、混合性肿物和多发性肿物表现的比例分别为80.6%(25/31)、9.7%(3/31)和80.6%(25/31),包膜侵犯和甲状腺外侵犯发生率均为25.8%(8/31),对照组分别为65.6%(21/32)、3.1%(1/32)、65.6%(21/32)、43.8%(14/32)、21.9%(7/32),两组比较差异均具有显著性(P<0.05)。结论乳头状甲状腺癌合并HT的患者在临床特点上主要以甲状腺分泌功能改变、混合性和多发性肿物、包膜侵犯和甲状腺外侵犯为主要特点,HT患者应定期体检。Objective To analyze the clinical characteristics of papillary thyroid carcinoma merger hashimoto＇s thyroiditis（HT）, in order to provide reference for disease control and prevention. Method63 cases of papillary thyroid carcinoma patients were selected as the research objects who accepted the diagnosis and treatment from February 2006 to February 2011 in our hospital. 31 patients with combined HT as experimental group, another 32 cases as control group, analyzed the HT for the incidence of thyroid cancer, and thyroid function, imaging and pathological change characteristic in the two groups. Result The incidence of papillary thyroid carcinoma was 29.0%（31/107） with HT, and 10.3%（32/311） unincorporated HT; the increase rate of FT3, TGAb and TPOAb in experimental group were 3.2%（1/31）, 64.5%（20/31） and 71.0%（22/31）, while the rate were 9.4%（3/32）, 34.4%（11/32） and 37.5%（12/32） in control group, the differences were statistically significant by chi-square test（P〈0.05）. Patients with low echo, mixed the mass, and the characteristics of the multiple mass ratio in experimental group were 80.6%（25/31）, 9.7%（3/31） and 80.6%（25/31）, and capsular invasion and thyroid attack rate were all 25.8%（8/31）, compared with control group [65.6%（21/32）, 3.1%（1/32）, 65.6%（21/32）, 43.8%（14/32）, 21.9%（7/32）], the differences were statistically significant by chi-square test（P〈0.05）. Conclusion The clinical characteristics of papillary thyroid carcinoma patients with HT mainly by changes in thyroid function, mixed and multiple lesions, capsular invasion and thyroid invasion as main characteristic; regular medical monitoring should implement to the papillary thyroid carcinoma patients with HT.

关 键 词：甲状腺癌 桥本甲状腺炎 临床特点 

分 类 号：R736.1[医药卫生—肿瘤]