甲状腺乳头状癌伴桥本氏甲状腺炎临床病理分析  

Department of Clinicopathological analysis of papillary thyroid carcinoma with Hashimoto’s thyroiditis

作　　者：田志刚 陈立 柳子钰 乐宇庭 贾兰宁 韩悦[1] 何向辉[1,2] Tian Zhigang;Chen Li;Liu Ziyu;Le Yuting;Jia Lanning;Han Yue;He Xianghui(Departmant of General Surgery,General Hospital of Tianjin Medical University,Tianjin 300052,China;Tianjin Institute of General Surgery,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院普通外科,天津300052 [2]天津市普通外科研究所,天津300052

出　　处：《中华内分泌外科杂志》2023年第1期24-28,共5页Chinese Journal of Endocrine Surgery

基　　金：国家自然科学基金(81672641)。

摘　　要：目的讨论桥本氏甲状腺炎(Hashimoto’s thyroiditis,HT)对甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的影响。方法回顾性分析天津医科大学总医院甲状腺乳腺疝外科2019年1月1日至2021年5月1日初次就诊行手术治疗且术后病理证实为PTC的682例患者的临床特点及病理特征,其中男189例,女493例,<55岁529例,≥55岁153例;根据是否合并HT,分为PTC组和PTC合并HT组,应用χ^(2)检验比较两组在性别、年龄、甲状腺球蛋白抗体(thyroglobulin autoantibodies,TgAb)、促甲状腺激素(thyroid stimulating hormone,TSH)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、促甲状腺激素受体抗体(thyrotropin receptor antibody,TRAb)、癌胚抗原(carcinoembryonic antigen,CEA)、病灶数量、中央区淋巴结转移(central lymph node metastasis,CLNM)、是否微小癌、脉管浸润、腺外侵犯、被膜侵犯和侧颈淋巴结转移(lymph node metastasis,LNM)、超声钙化等方面的差异,分析HT对PTC的影响。同时将全部患者分为无CLNM组和伴CLNM组,应用χ^(2)检验比较两组在性别、年龄、病灶数量、是否微小癌、脉管浸润、腺外侵犯、被膜侵犯和侧颈LNM、超声钙化等方面的差异,分析两组在临床特点上的差异。结果PTC合并HT组206例(30.21%),不伴HT的PTC组476例(69.79%);两组在男/女(12/194 vs 177/299)(P=0.000)、年龄<55/≥55岁(175/31 vs 354/122)(P=0.002)、TgAb(115/91 vs 455/21)(P=0.000)、TSH(13/175/18 vs 33/429/14)(P=0.004)、TPOAb(90/116 vs 422/54)(P=0.000)、病灶数量(114/92 vs 325/151)(P=0.001)、CLNM(87/119 vs 250/226)(P=0.014)方面差异具有统计学意义(P<0.05),在TRAb(196/10 vs 461/15)(P=0.171)、CEA(205/1 vs 469/7)(P=0.478)、是否微小癌(136/70 vs 309/167)(P=0.781)、脉管浸润(4/202 vs 16/460)(P=0.446)、腺外侵犯(52/154 vs 108/368)(P=0.470)、被膜侵犯(149/57 vs 358/118)(P=0.429)和侧颈LNM(31/175 vs 72/404)(P=0.979)、超声钙化(157/49 vs 392/84)(P=0.063)方面差异无统计学意义,且�Objective To discuss the effect of Hashimoto’s thyroiditis(HT)on papillary thyroid carcinoma(РТС).Methods The clinical features and pathological characteristics of 682 patients who underwent surgical treatment for the first time from Sep.1st,2019 to May.1st,2021 in Department of Thyroid,Breast and Hernia Surgery,and confirmed by postoperative pathology as papillary thyroid carcinoma were retrospectively analyzed.There were 189 male patients,and 493 female patients,529 patients<55 years old and 153 patients≥55 years old.476 patients were classified as PTC group and 206 patients as PTC combined with HT group.Chi square test was used to compare the difference between two groups in gender,age,thyroglobulin antibody,thyroid stimulating hormone,thyroid peroxidase antibodies,thyroid peroxidase,number of lesions,metastasis lymph node in central region,thyroid stimulating hormone receptor antibody,carcinoembryonic antigen,whether microcarcinoma,vascular invasion,glandular outside violation,capsule and lateral transfer analysis,ultrasonic calcification,etc.At the same time,all patients were divided into the group without central lymph node metastasis(345 cases)and the group with central lymph node metastasis(337 cases).Theχ^(2) test was used to compare the differences between the two groups in terms of sex,age,number of lesions,microcarcinoma,vascular invasion,extradular invasion,capsular invasion,lateral cervical lymph node metastasis,ultrasonic calcification and so on,so as to analyze the differences in clinical characteristics between the two groups.Results There were 206 cases(30.21%)in PTC combined with HT group and 476 cases(69.79%)in PTC without HT group.There were significant differences in gender(12/194 vs 177/299)(P=0.000),age(175/31 vs 354/122)(P=0.002),TgAb(115/91 vs 455/21)(P=0.000),TSH(13/175/18 vs 33/429/14)(P=0.004),TPOAb(90/116 vs 422/54)(P=0.000),number of lesions(114/92 vs 325/151)(P=0.001)and lymph node metastasis in central area(87/119 vs 250/226)(P=0.014)between the two groups(P<0.05),but ther

关 键 词：甲状腺乳头状癌 桥本氏甲状腺炎 淋巴结转移 侵犯 钙化 

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