甲状腺乳头状癌合并桥本甲状腺炎的临床病理研究  

Clinicopathologic characteristics of papillary thyroid carcinoma with concomitant Hashimoto's thyroiditis

作　　者：茅建娅 王薇[1] 别克扎提 耿中利[1] 

机构地区：[1]新疆医科大学第四附属医院外一科二组,新疆乌鲁木齐830011

出　　处：《中国普通外科杂志》2016年第5期665-669,共5页China Journal of General Surgery

摘　　要：目的:探讨桥本甲状腺炎(HT)与甲状腺乳头状癌(PTC)之间的关系。方法:回顾性分析2010年1月—2015年5月495例接受手术治疗,术后病理诊断为PTC的患者资料,比较伴有和不伴有HT患者的临床病理特点。结果:495例PTC患者中,伴发HT者108例(21.81%)。单因素分析结果显示,与单纯PTC患者比较,PTC并HT患者中女性多见(90.7% vs.71.6%)、术前促甲状腺激素(TSH)水平(4.04 μIU/mL vs.2.76 μIU/mL)及甲状腺过氧化物酶抗体(TPOAb)水平偏高(94.31 IU/mL vs.33.65 IU/mL)、肿瘤最大径偏小(1.10 cm vs.1.31 cm)、临床分期偏早(I期87.1% vs.76.8%),差异均有统计学意义(均P<0.05)。Logistic回归分析显示,患者的性别、TSH水平、TPOAb水平、临床分期是PTC合并HT的独立预测因素(均P<0.05)。结论:PTC合并HT患者中,女性较多,临床分期较早,并且肿瘤偏小,提示合并HT并未增加PTC的侵袭性,预后较好。但合并HT的患者TSH水平偏高,提示HT可能是PTC的发病风险因素之一。Objective： To investigate the relationship between Hashimoto＇s thyroiditis（HT） and papillary thyroid carcinoma（PTC）. Methods： The clinical data of 495 patients who underwent surgical treatment and diagnosed as PTC by postoperative pathological examination from January 2010 to May 2015 were reviewed. The clinicopathologoic characteristics between patients with and without concomitant HT were compared.Results： Among the 495 PTC patients, 108 cases（21.81%） had concomitant HT. Results of univariate analysis showed that in PTC patients with concomitant HT compared with those without HT, female cases were more frequent（90.7% vs. 71.6%）, the preoperative levels of thyroid stimulating hormone（4.04 μIU/mL vs. 2.76 μIU/mL） and thyroid peroxidase antibody（TPOAb）（94.31 IU/mL vs. 33.65 IU/mL） were elevated, maximum tumor diameter was shorter（1.10 cm vs. 1.31 cm） and the number of cases witThearly clinical stage was increased（stage I： 87.1% vs. 76.8%）, and all differences had statistical significance（all P〈0.05）. Logistic regression analysis showed that gender, TSH level, TPOAb level and clinical stage were independent predictors for PTC combined with HT（all P〈0.05）. Conclusion： PTC patients with concomitant HT present with female predominance, earlier clinical stage, and small size, suggesting that the combined HT may not increase the invasiveness of PTC, and may have a relatively good prognosis. However, the TSH level is increased in patients with concomitant HT, which suggests that HT may be one of the risks for PTC.

关 键 词：甲状腺肿瘤 桥本病 病理学 临床 

分 类 号：R736.1[医药卫生—肿瘤]