摘要
目的回顾性分析甲状旁腺功能亢进合并分化型甲状腺癌的诊断和手术治疗策略。方法回顾性分析2009年1月至2012年12月北京协和医院384例接受手术治疗甲状旁腺功能亢进病人的临床资料,分析合并分化型甲状腺癌的甲状旁腺功能亢进病人的发生率及临床诊治特点。结果所有病人均得到病理学确诊,其中包括原发性甲状旁腺功能亢进367例。术后病理诊断发现腺瘤286例、增生84例及腺癌14例。12例原发性和1例继发性甲状旁腺功能亢进病人经病理诊断为同时合并分化型甲状腺癌,包括12例甲状腺乳头状癌及1例甲状腺滤泡状癌。是否合并分化型甲状腺癌与甲状旁腺功能亢进病人的年龄、性别、甲状旁腺病理类型均不相关。结论甲状旁腺功能亢进合并分化型甲状腺癌是一类少见的病例,常规术前甲状腺超声检查及PTH检测将有助于明确术前诊断,从而改变手术策略,提高手术疗效,减少不必要的再次手术带来的风险。
Objective To investigate the strategy of diagnosis and surgery for hyperparathyroidism in patients with differentiated thyroid carcinomas. Methods The clinical data of 384 patients with hyperparathyroidism who had underwent parathyroidectomy between January 2009 and December 2012 in Peking Union Medical College Hospital were analyzed retrospectively for coexistent differentiated thyroid carcinomas. Results All the patients were confirmed by pathology. A total of 367 patients were with primary hyperparathyroidism. The final pathological diagnoses of the parathyroid lesions included adenoma （n--286）, adenoeaeinoma （n=14） and hyperplasia （n=84）. A total of 12 patients with primary hyperparathyroidism and 1 patient with secondary hyperparathyroidism were complicated with differentiated thyroid carcinoma, which included papillary carcinoma in 12 patients and follicular carcinoma in 1 patient. Whether complicated with differentiated thyroid carcinoma and hyperparathyroidism patients＇ age, gender, parathyroid pathological type was not related. Conclusion Hyperparathyroidism complicated with differentiated thyroid carcinoma is a rare condition. Routine preoperative thyroid uhrasonography and parathyroid hormone measurement may help to improve the surgical effectiveness and avoid unnecessary reoperations.
出处
《中国实用外科杂志》
CSCD
北大核心
2014年第4期329-331,共3页
Chinese Journal of Practical Surgery
