淋巴细胞性甲状腺炎合并甲状腺乳头状癌18例分析

Analysis on 18 cases of lymphocytic thyroiditis complicated with papillary thyroid carcinoma

目的探讨淋巴细胞性甲状腺炎(HT)合并甲状腺乳头状癌(PTC)患者的病因、病理相关性及诊断与治疗。方法回顾性分析我科自2006年2月—2011年2月收治的18例HT合并PTC患者的临床资料。结果 18例患者术前彩超均发现甲状腺低回声团块,发现伴钙化灶7例,提示恶性者2例。术前甲状腺球蛋白抗体(TG-Ab)升高7例,甲状腺过氧化物酶抗体(TPO-Ab)升高4例,两者均升高3例。1例行细针穿刺活检(FNA)确诊为乳头状癌。所有患者均行手术治疗。结论 HT与PTC病因、病理上呈明显的相关性,术前结合TG-Ab、TPO-Ab、超声检查、FNA综合分析有助于HT合并PTC的诊断,手术治疗是针对HT合并PTC的有效治疗方法,我们应打破传统HT内科治疗,高度警惕HT合并PTC。

Objective To investigate the etiological factors, pathological correlation, diagnosis and treatment in patients with lymphocytic thyroiditis （ Hashimoto＇ s thyroiditis, HT） complicated with papillary thyroid carcinoma （PTC）. Methods The clinical data of 18 patients with HT and PTC in our department from February 2006 to February 2011 were retrospective analyzed. Results 18 cases of patients with low-echo mass were confirmed by preoperative color Doppler ultrasound, 7 cases with calcification were found, 2 cases with malignant tumor. Preoperative thyroid globulin antibody （TG-Ab） increased in 7 patients, thyroid perexidase antibodies （TPO-Ab） increased in 4 cases, both increased in 3 cases. 1 case underwent fine-needle aspiration biopsy （FNA） and was diagnosed with papillary carcinoma. All of the patients underwent surgery treatment. Conclusion The etiology and pathology of HT and PTC were significantly associated with each other. Comprehensive analysis of preoperative TG-Ab, TPO-Ab, ultrasonic examination and FNA is helpful to diagnose HT complicated with PTC. Surgical treatment is the effective method for treatment of HT complicated with PTC. We should break the traditional idea of HT medical treatment; High vigilance should be kept for HT complicated with PTC.