桥本氏病合并甲状腺癌11例诊治分析

Diagnosis and treatment of 11 cases of Hashimoto's disease complicated with thyroid cancer

目的探讨桥本氏病合并甲状腺癌的临床特点及诊断治疗经验。方法回顾分析本院2005年1月至2010年1月间收治的11例桥本氏病合并甲状腺癌患者的临床资料。11例患者均经手术治疗。>1cm的肿瘤行癌侧甲状腺全切除、甲状腺峡部全切、健侧甲状腺次全切除及择区性颈淋巴结清扫术,共9例。<1cm肿瘤则仅行癌侧甲状腺次全切除术加Ⅵ区颈淋巴结清扫术,共2例。结果桥本氏病合并甲状腺癌发生率为12.7%(11/86),其中乳头状癌9例,滤泡状癌2例。随访1～5年无复发。结论桥本氏病合并甲状腺癌发生率高,手术仍是最有效的治疗方法,术前穿刺,术中病理对于诊断和术式选择具有重要意义。

Objective To investigate the clinical features, diagnosis and treatment for Hashimoto＇s disease complicated with thyroid cancer. Methods The clinical data of 11 cases of Hashimoto＇s disease with thyroid cancer treated by surgery from Jan. 2005 to Jan. 2010 were retrospectively analyzed. Nine patients with tumors greater than 1 cm were treated by line side of the thyroid cancer resection, total resection of the thyroidisthmus contralateral subtotalthyroidectomy and selective neck lymph node dissection. The remaining 2 patients with tumors smaller than 1 cm were only treated by line side of the thyroid cancer subtotalthyroidectomy and neck lymph node dissection of region VI. Results The incidences for Hashimoto＇s disease complicated with thyroid cancer is 12.7% （11/86）, including 9 cases of papillary thyroid carcinoma, 2 cases of follicular thyroid carcinoma. No evidence of recurrence was found during the follow-up of 1～5 years after surgery. Conclusion Operation remains the most effective treatment for Hashimoto＇s disease complicated with thyroid cancer. Preoperative paracentesis and intraoperative pathology play a significant role in the diagnosis and surgical procedure.