老年甲状腺癌临床及病理特点分析  

Clinical and pathologic characteristics of elderly patients with thyroid carcinoma

作　　者：刘嘉[1] 杨昆宪[1] 纳智明[1] 陈居敏[1] 李莉[1] 

机构地区：[1]云南省第一人民医院肿瘤外科

出　　处：《老年医学与保健》2015年第5期304-306,共3页Geriatrics & Health Care

摘　　要：目的探讨老年甲状腺癌的临床及病理学特点。方法收集2012年10月-2014年10月收治的老年甲状腺癌54例临床资料，从就诊时间、病理类型、肿瘤大小、临床分期、淋巴结转移情况、远处转移等角度进行分析。并按体检后就诊与非体检后就诊进行分组比较分析。结果（1）乳头状癌比例为88．9％，其中微小乳头状癌占39．6％；髓样癌为5．6％，未分化癌为3．7％，滤泡状癌为1．8％。早期（I期＋II期）所占比例为77．8％；（2）体检后就诊的病例就诊时间明显短于非体检后就诊的病例（1m vs 8m）。2组问肿瘤的大小[（1．48±0．75）cm vs （2．37±2．08）cm]、中晚期患者（III期＋Ⅳ期）所占比例（7．8％W35．7％）也有明显差异。结论乳头状癌是老年性甲状腺癌最主要的病理类型；老年甲状腺癌表现的高恶性度、高侵袭性与诊断治疗迟滞明显相关；常规B超检查对提高老年甲状腺癌的早期诊断率及改善预后有显著的作用。Objective To explore the clinical and pathological characteristics of thyroid carcinoma in elderly patients. Methods The clinical records of 54 elderly cases with thyroid carcinoma in the First people＇s Hospital of Yunnan Province from October 2012 to October 2014 were analyzed retrospectively. Data were gathered for the visiting time, pathologic clas- sification, clinical stage, tumor size, the presence of lymph node （LN） and distant metastasis. Then patients were divided into two groups： those seek medical after health checking （group A） or non- health checking （group B）, and analyzed again. Results A majority of the pathology was papillary thyroid carcinoma （88.9 %, including papillary microcarcinoma in 39.6 %）, followed by medullary thyroid carcinoma （5.6 %）, undifferentiated thyroid carcinoma （3.7 %） and follicular adenocarcinoma （1.8%）. early （stage I, II） patients accounted for a higher proportion （77.8%）.There were significant differences between group A and group B in the visiting time （1 months vs 8 months）, tumor size （1.48±0.75）cm vs （2.37±2.08） cm and the pro- portion of advanced （ stage Ⅲ, IV） patients （7.8 % vs 35.7 %）. Conclusion Papillary thyroid carcinoma is the main pathology type in elderly patients. Diagnostic delay may cause the more aggressive of thyroid carcinoma in elderly patients. Routine B- ultrasound may be very helpful to enhance early diagnosis rate and improve prognosis in elderly thyroid carcinoma.

关 键 词：甲状腺癌 老年 临床 病理学 

分 类 号：R736.1[医药卫生—肿瘤]