68例结节性甲状腺肿并发甲状腺癌的临床分析

Clinical Analysis of 68 Cases of Nodular Goiter Complicating Thyroid Cancer

目的研究结节性甲状腺肿并发甲状腺癌病理情况和相关临床分析。方法分析2008年5月至2010年5月我院甲状腺肿并发甲状腺癌计68例患者的临床资料以及病理资料,同时随机性选用相同时期单纯性甲状腺肿病例98例作为对照研究。结果结节性甲状腺肿并发甲状腺癌性别比例大致为2∶3。该病发病年龄约在45～60岁,肿瘤<2cm约占63.2%,其中TNM分期以Ⅰ期病例为主,为70.6%。病理类型主要是乳头状癌,数据比例为89.7%。含微小癌30例,占49.2%,研究的68例癌变组织里,含砂粒体以及钙化发生率是45.6%,显著比98例单纯甲状腺肿含砂粒体发生率32.7%要高,差异具有统计学意义(P<0.05)。以患侧腺叶和峡部全切除以及对侧腺叶次全切除作为主要的手术手段,其中31例加作颈部淋巴结清扫。结论结节性甲状腺肿并发甲状腺癌是以女性性别为主,肿瘤特点通常<2cm,Ⅰ期和乳头状癌,大都含有砂粒体。对该病进行早期诊断以及有效的治疗对改善患者预后影响有很大帮助。

Objective Research nodular goiter complicating pathological conditions and clinical analysis of thyroid cancer. Method Analysis the May 2008 to May 2010 in our hospital goiter complicating thyroid cancer 68 patients＇ pathological data and clinical data. Randomness chooses the same period 98 cases of simple goiter as a compare study. Results Nodular goiter complicating thyroid cancer sex ratio is approximately 2 ： 3. The age of onset of the disease is about 45-60 years old. About 63.2% of tumors is less than 2cm. TNM staging mainly Phase I cases, is 70.6%. Pathological type is main papillary carcinoma, data ratio of 89.7%. Tiny cancer contains 30 cases, accounting for 49.2%. Study of 68 cases of cancerous tissue, containing psammoma bodies and calcification incidence is 45.6%. Significantly more than 98 cases of simple goiter containing psammoma bodies 32.7% incidence. The difference was statistically significant （P〈0.05）. As the primary means, affected side lobe and the isthmus total resection while contra lateral side lobe subtotal. 31 cases do neck lymph node dissection. Conclusion Female get Nodular goiter complicating thyroid cancer as main. The tumor characteristics usually less than 2 cm, I period and papillary carcinoma, most containing sand body. That is to say, early diagnosis and effective treatment can improve the prognosis of patients.