桥本病并发甲状腺癌临床分析

CLINICAL ANALYSIS OF HASHIMOTO DISEASE COMPLICATED WITH THYROID CANCER

目的探讨桥本病并发甲状腺癌的临床发病关系及诊断、治疗和预后。方法回顾性分析1989—2004年56例桥本病并发甲状腺癌7例资料。结果本组桥本病并发甲状腺癌发病率为12.5%(7/56)。全组出现甲状腺结节的患者均进行了手术治疗,甲状腺癌7例平均随访6.5年无死亡及复发,预后好。结论对于并发甲状腺结节的桥本病应考虑手术治疗。桥本病并发甲状腺癌临床诊断较困难。术前常规测血抗甲状腺球蛋白抗体(ATGA)、抗微粒体抗体(MCA)、甲状腺核素显影、细针穿刺、术中快速冰冻切片,有利于术前、术中确诊及正确的手术方式选择。

Objective To study the clinical relationship between Hashimoto disease and thyroid cancer and its diagnosis, treatment and prognosis results. Methods Restrospective analysis was made on 56 cases with Hashimoto disease treated from 1989-2004, in which 7 cases were coexistent with thyroid carcinoma. Results The incident rate of thyroid carcinoma was 12.5% （7/56）. All patients with nodules received thyroidectomy. All postoperative patients were followed up. The average survival period of thyroide cancer was 6.5 year and without recurrence. Conclusion Patients with nodules should be treated by surgery. The clinical diagnosis of coexistence of Hashimoto disease and thyroid cancer is still difficult. The key to diagnosis and rational treatment includes detailed understanding of clinical feature, routine examination of serum antibodies and scintigraphic thyroid scan or FNAB and quick frozen pathologic section in operation.