甲状旁腺囊肿临床病理分析和外科治疗

Clinicopathological characteristics and surgical management of parathyroid cysts

目的探讨甲状旁腺囊肿的临床病理特征、诊断和外科治疗。方法分析18例甲状旁腺囊肿的临床资料含病理学及免疫组织化学的特征，并复习相关文献。结果本组18例中，8例为功能性，男女比3：1，部位右下叶多于左下叶，甲状旁腺素水平均增高，4例伴甲旁亢症状；10例非功能性，均为女性，部位左下叶多于右下叶，不伴甲旁亢症状。均行手术切除治疗，其中3例曾经细针穿刺抽吸而反复复发，病理学检查证实均为甲状旁腺囊肿，免疫组织化学检查甲状腺球蛋白阴性排除甲状腺囊肿而支持本诊断。术后随访均无复发，甲旁亢症状缓解。结论功能性和非功能性甲状旁腺囊肿，两者有不同的I临床特征及可能不同的组织学起源，病理学检查是最可靠的诊断方法，治疗均应以手术为主。

Objective To investigate the clinicopathological characteristics of parathyroid cysts （PTC） for its diagnosis and surgical management. Methods The clinical date, the pathology features and immuohisto- chemisitry characteristics were analyzed in eighteen cases parathyroid cysts, and related literatures were reviwed. Results The eight functional PTCs （FPTCs） of 18 cases with a man versus woman ratio of 3 to 1, more cysts lo- cated in the right inferior glands than in the left inferior glands, high parathyroid hormone levels were found in these 8 cases and hyperparathyroidism in 4 cases. The ten nonfunctional PTCs （NFPTCs） of 18 cases were fe- male, cysts located more frequently in the left than in the right inferior glands, and no hyperparathyroidism. All cases underwent operation and diagnosis was confirmed by pathology. A repeated ultrasound-guided aspiration was performed in 3 cases with repeated recurrence. The tumors were negative for Thyroglobulin（Tg） on immunohisto- chemical staining, that excluded the posibility of thyroid cyst. Conclusions FPTCs and NFPTCs have different clinical features and probably separated histological origin. The diagnosis is made by pathologic examination, surgical resection is most effective in treating PTC.