不同病理类型并存的甲状腺恶性肿瘤临床分析

Mixed thyroid malignant tumors

目的探讨不同病理类型并存的甲状腺恶性肿瘤的临床诊断、治疗方法和预后。方法对1977年1月-2006年12月收治的7例不同病理类型并存的甲状腺恶性肿瘤病例进行回顾性分析。结果不同病理类型并存的甲状腺恶性肿瘤占本院同期甲状腺恶性肿瘤的0．14％，影像学及实验室检查均无特异性诊断价值，不同病理类型并存的甲状腺癌采用甲状腺癌根治手术配合内分泌治疗及^131I治疗可取得满意疗效，甲状腺癌合并甲状腺其他恶性肿瘤预后差。结论不同病理类型并存的甲状腺恶性肿瘤属于罕见疾病，发病机制尚不明确，命名也不统一，目前尚无特异性诊断方法，其预后取决于恶性程度最高的病理类型。

Objective To study the diagnosis, treatment and prognosis of mixed thyroid malignant tumors. Methods Clinical data of 7 cases with merged different histological types of thyroid malignant tumor treated from January 1977 to December 2006 were retrospectively analyzed. Results Merged different histologie types of thyroid malignant tumor accounted for 0. 14% of all thyroid malignant tumors treated during this period. Preoperative imaging and laboratory data had no specific value in the diagnosis of this merged different histologic types of thyroid malignant tumors. Radical resection in combination of hormonal therapy and t31I radiotherapy achieved a satisfactory result, though thyroid malignant tumor combined with thyroid cancer usually predict a poor prognosis. Conclusions Merged different histologic types of thyroid malignant tumor is a rare clinical entity, with the pathogenesis being obscure and no consensus of opinion on its nomenclature. The prognosis depends on the highest grade among an individual group of malignant tumors.