甲状腺嗜酸细胞肿瘤15例诊治分析

Diagnosis and treatment of Hurthle cell tumors of thyroid:an analysis of 15 cases

目的进一步探讨甲状腺嗜酸细胞肿瘤的临床诊断和治疗。方法分析2001-2007年上海交通大学医学院附属瑞金医院外科诊治15例甲状腺嗜酸细胞肿瘤的临床资料、手术方式和苏木精伊红染色(HE)切片结果。结果14例经病理证实为嗜酸细胞腺瘤,1例为一侧嗜酸细胞腺瘤合并对侧嗜酸细胞腺癌。术中冰冻切片仅有6例明确诊断,其余均依赖术后石蜡切片确诊。行患侧全切或近全切除3例,患侧次全切除12例。随访1～7年,中位随访时间38个月,无复发及死亡。结论甲状腺嗜酸细胞肿瘤有潜在恶性可能,手术是治疗嗜酸细胞肿瘤的有效手段。

Objective To investigate the diagnosis and treatment of Hurthle cell tumors （HCT） of the thyroid. Methods The clinical data of 15 cases of HCT admitted between 2001 and 2007 at Ruijin Hospital of Medical School of Shanghai Jiaotong University were analyzed. Results Forteen cases of Hurthle cell adenomas were diagnosed by pathology. One case of Hurthle cell adenomas were complicated with Hurthle cell follicular carcinoma on the opposited side of thyroid. Only 6 cases were diagnosed by frozen section examination during the operation, the others could only be confirmed by paraffin section examination finally. Surgical procedure ：3 cases of total or near total thyroidectomy and 12 cases of sub-total desection were performed. The follow-up periods varied from 1 year to 7 years, and median follow-up time was 38 months. No recurrence and death were observed during the follow-up periods. Conclusion There are evidences that HCT is a potential malignant neoplasm. Surgery is the effective way for HCT.