甲状腺髓样癌合并桥本甲状腺炎的临床病理特征及预后分析  

Clinicopathological and prognostic analysis of medullary thyroid carcinoma co-existent with Hashimoto's thyroiditis

作　　者：刘伟[1] 崔艳梅[2] 彭凤英 杨世娟 朱伟峰[1] 肖伟进 钟礼花[1] Liu Wei;Cui Yanmei;Peng Fengying;Yang Shijuan;Zhu Weifeng;Xiao Weijin;Zhong Lihua(Department of Pathology,Fujian Medical University Cancer Hospital,Fujian Cancer Hospital,Fuzhou 350014,China;Department of Pathology,People's Hospital,Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China)

机构地区：[1]福建医科大学附属肿瘤医院福建省肿瘤医院病理科,福州350014 [2]福建中医药大学附属人民医院病理科,福州350004

出　　处：《中华普通外科杂志》2022年第9期684-688,共5页Chinese Journal of General Surgery

摘　　要：目的探讨甲状腺髓样癌合并桥本甲状腺炎的临床病理特征及预后。方法回顾性分析2007年1月至2021年5月在福建省肿瘤医院确诊的7例甲状腺髓样癌合并桥本甲状腺炎患者的临床资料,分析其临床特点、病理学及预后。结果本组7例患者均为成年女性,中位年龄49岁,6例为单侧甲状腺髓样癌病变,肿瘤直径0.4~7.0 cm。肿瘤周围甲状腺呈桥本甲状腺炎改变。随访时间16~152个月,中位随访时间61个月,5例(肿瘤直径<1 cm)生化治愈,1例(肿瘤直径>1 cm)解剖治愈。1例患者术后30个月因肿瘤进展而死亡,该病例的肿瘤细胞异型性大、核分裂易见(5~8个/10 HPF),可见坏死及脉管侵犯。结论甲状腺髓样癌合并桥本甲状腺炎多为散发性病例,大多数患者的预后较好。Objective To investigate the clinicopathological features and prognosis of medullary thyroid carcinoma(MTC)co-existent with Hashimoto's thyroiditis(HT).Methods Seven cases of MTC co-existent with HT were collected from Fujian Cancer Hospital between Jan 2007 and May 2021.Its clinicopathological features were analyzed.Results All patients were adult female with a median age of 49 years,and 6 of them were unilateral MTC.The tumor diameter ranged from 0.4 to 7.0 cm.The thyroid tissue surrounding the tumor showed HT.The follow-up time was 16 to 152 months,with a median time of 61 months,5 patients(tumor diameter<1 cm)were biochemically cured,1 patient(tumor diameter>1 cm)was anatomically cured.The another patient died due to tumor progression 30 months after surgery,the tumor cells in which were highly atypia and more mitoses(5~8/10HPF)necrosis and vascular invasion were also observed.Conclusion MTC with HT are mostly sporadic cases,and most of them have a fair prognosis.

关 键 词：甲状腺肿瘤 甲状腺炎 自身免疫性 降钙素 病理学 临床 预后 

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