合并乳腺癌的甲状腺癌152例临床病理学特征分析  

Clinicalpathological Characteristics of 152 Thyroid Cancer Patients with Breast Cancer

作　　者：俞斌 黄煜庆 曹君[2] 朱栩杭 钟欢欣 葛明华[2] YU Bin;HUANG Yu-qing;CAO Jun(The 2nd Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053, China;Zhejiang Cancer Hospital, Hangzhou 310022, China)

机构地区：[1]浙江中医药大学第二临床医学院,浙江杭州310053 [2]浙江省肿瘤医院,浙江杭州310022

出　　处：《肿瘤学杂志》2018年第4期313-317,共5页Journal of Chinese Oncology

基　　金：浙江省医药卫生平台计划(2015DTA003);国家自然科学基金资助项目(81672642)

摘　　要：目的]探讨有乳腺癌病史的甲状腺癌患者的临床病理学特征。[方法]回顾性分析浙江省肿瘤医院2006~2016年间收治的合并乳腺癌的152例甲状腺癌患者的临床病理资料。152例患者均为女性,中位年龄50（28~74）岁,中位随访时间36（9~115）个月。[结果]共5例出现复发转移（3例远处转移,2例局部转移）,共2例因乳腺癌死亡。同时性多原发癌TC=BC组37例,异时性多原发癌甲状腺癌首发TC^1→BC^2组16例,异时性多原发癌乳腺癌首发BC^1→TC^2组99例。BC^1→TC^2组与TC^2控制对照组淋巴结转移率（39.39%vs28.28%,P=0.039）、是否微小癌（76.77%vs 65.99%,P=0.048）差异有统计学意义;152例患者中超重组患者（BMI〉24kg/m^2,n=50）的肿瘤大小、甲状腺被膜侵犯率均高于正常体重组患者（BMI≤24kg/m^2,n=102）,差异均有统计学意义（P=0.048,P=0.029）。[结论]乳腺癌首发的甲状腺癌患者淋巴结转移率更高,尤在超重患者中肿瘤更具侵袭性。对此类患者术前应详细评估可疑淋巴结再拟定手术方案,术中应仔细探查中央区淋巴结转移情况,必要时行侧颈淋巴结清扫。[Objective]To analyze the clinicalpathological characteristics of thyroid cancer patients with breast cancer history.[Methods]The clinicopathological data of 152 cases of thyroid cancer patients with breast cancer history admitted between 2006 and 2016 were retrospectively analyzed.The 152 patients were all female with a median age of 50（28~74）years,median followup time of 36（9~115）months.[Results]Among 152 patients,there were 5cases of recurrence or metastasis（3 of distant metastasis and 2 of local metastases）;37 cases of synchronous thyroid and breast cancers and 115 cases of metachronous breast and thyroid cancers,including 99cases of thyroid carcinoma after breast carcinoma（TC^1→BC^2）and 16 cases of breast carcinoma after thyroid carcinoma（BC^1→TC^2）.There were significant differences in the lymph node metastasis（39.39%vs 28.28%,P=0.039）and in microcarcinoma（76.77%vs 65.99%,P=0.048）between the BC^1→TC^2group and TC^2control group.The tumor size and the extrathyroid extension rate were all higher in overweight group（BMI24kg/m^2,n=50）than those in the normal weight group（BMI24kg/m^2,n=102）,and the difference was statistically significant（P=0.048,P=0.029）.[Conclusion]Thyroid cancer patients after breast cancer have a higher rate of lymph node metastasis,especially in overweight patients.A detailed evaluation of the suspected lymph node should be performed before surgery,and the lymph node metastasis in the central region should be investigated carefully,and lateral neck dissection should be performed if it is necessary.

关 键 词：甲状腺肿瘤 乳腺肿瘤 临床病理学特征 多原发癌 体质指数 

分 类 号：R736.1[医药卫生—肿瘤]