桥本甲状腺炎合并甲状腺癌51例临床分析  

Clinical analysis of 51 cases of Hashimoto's thyroiditis complicated with thyroid carcinoma

作　　者：张永刚[1] 郝智[1] 吕佳[1] 蒋志斌[1] 刘斌[2] 

机构地区：[1]河北大学附属医院头颈外科,保定071000 [2]河北大学附属医院肿瘤内科,保定071000

出　　处：《疑难病杂志》2016年第6期634-636,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：保定市科学技术研究与发展指导计划项目(13ZF022)

摘　　要：目的分析桥本甲状腺炎合并甲状腺癌的临床病理特点及临床诊治情况。方法回顾性分析2009年1月-2014年5月河北大学附属医院头颈外科经病理证实的桥本甲状腺炎患者184例,其中合并甲状腺癌患者51例,对其临床资料进行分析。结果 51例桥本甲状腺炎合并甲状腺癌患者中,双侧甲状腺癌16例（31.37%）,单侧甲状腺癌35例（68.62%）。乳头状癌49例（96.07%）,其中微小乳头状癌35例（68.62%）;滤泡状癌1例（1.96%）;髓样癌1例（1.96%）。合并双侧叶甲状腺癌的患者常规行甲状腺全切＋中央区淋巴结清扫术16例（31.37%）,合并单侧甲状腺癌的患者行患侧叶及峡叶切除＋常规中央区淋巴结清扫术34例（68.62%）,合并髓样癌的患者行甲状腺全切＋中央区淋巴结清扫术1例（1.96%）。合并乳头状癌的患者出现侧颈淋巴结转移8例,同期行侧颈淋巴结清扫。失访1例,随访50例,随访1.5-6年,无1例患者复发或死亡。结论桥本甲状腺炎易并发甲状腺癌,以微小乳头状癌为多,手术治疗预后良好。Objective To investigate the clinical pathological characteristics and clinical diagnosis and treatment of the Hashimoto＇s thyroiditis complicated with thyroid cancer.Methods From January 2009 to May 2014,retrospectively analysed 184 cases of patients with Hashimoto＇s thyroiditis confirmed by pathology in the Department of Head and Neck Surgery,Hebei University Affiliated Hospital,including 51 patients with thyroid cancer,and analysed their clinical materials.Results51 cases of Hashimoto＇s thyroiditis complicated with thyroid cancer patients,bilateral thyroid carcinoma in 16 cases（31.37%）,unilateral thyroid cancer in 35 cases（68.62%）.Papillary carcinoma in 49 cases（96.07%）,of which liny papillary carcinoma 35 cases（68.62%）.follicular carcinoma in 1 case（1.96%）,medullary carcinoma in 1 case（1.96%）.Palients combined with bilateral lobes of the thyroid cancer underwent conventional thyroid total resection and central area neck lymph nodes dissection in 16 cases（31.37%）,with unilateral thyroid cancer patients were performed lateral lobe and isthmus leaf excision and conventional central area lymph nodes dissection in 34 patients（68.62%）,with medullary carcinoma patient was performd total thyroidectomy and central area neck lymph nodes dissection in 1 case（1.96%）.8 cases with cervical lymph node metastasis occurred in patients with papillary carcinoma,neck lymph nodes dissection was performed at the same time.1 case was lost to follow-up,50 cases were followed up for 1.5 to 6 years,no recurrence or death occurred.Conclusion It demonstrated that the Hashimoto＇s thyroiditis was easy intercurrent the thyroid cancer,which commonly was tiny papillary carcinoma with better surgery prognosis.

关 键 词：桥本甲状腺炎 甲状腺癌 诊断 治疗 

分 类 号：R736.1[医药卫生—肿瘤] R581.4[医药卫生—临床医学]