甲状腺乳头状微小癌合并桥本甲状腺炎的临床病理分析

Clinicopathological data analysis in papillary thyroid microcarcinoma combined with Hashimoto's thyroiditis

目的研究甲状腺乳头状微小癌(PTMC)合并桥本甲状腺炎(HT)的临床病理特点,为临床诊治提供参考。方法:收集我院2010年10月-2013年9月收治并经手术病理证实为PTMC患者的临床病理资料,以是否合并HT分组比较,并进行回顾性分析。结果 119例PTMC中,男女比例1:2.6,年龄(44.4±12.4)岁,术前甲状腺功能正常者97例(81.5%),肿瘤平均最大径(6.8±2.3)mm,有颈部淋巴结转移36例(30.3%),合并HT 41例(34.5%)。与未合并HT组相比,合并HT组中女性更多,发病年龄较小,术前促甲状腺激素(TSH)较高,肿瘤最大径较小,相互比较存在统计学差异(P<0.05)。合并HT组的颈部淋巴结转移率(36.6%)稍高于未合并HT组(26.9%),且与年龄、肿瘤最大径显著相关。结论 PTMC合并HT在较年轻的女性、术前血TSH水平偏高者中较常见。起病年龄较小、癌灶最大径≥7.0 mm时更易发生颈淋巴结转移。

Objective To investigate the clinicopathologic characteristics of papillary thyroid microcarcinoma（PTMC） combined with Hashimoto’s thyroiditis（HT）. Methods A retrospective study was carried out on patients with pathologically confi rmed PTMC who underwent thyroidectomy between October 2010 and September 2013. Results Among 119 PTMC patients, M/F ratio is 1：2.6, mean age is 44.4±12.4 years, 97 cases（81.5%） had normal thyroid function, mean tumor size was（6.8±2.3） mm, 36 cases（30.3%）had cervical lymph node metastasis, 41 cases（34.5%）had coexistent HT. Compared to PTMC patients without HT, patients with HT displayed a greater female preponderance, younger age, higher preoperative TSH and smaller tumor size（P〈0.05）. Central lymph node metastasis rate in PTMC with HT is 36.6%, which was slightly higher than that without HT（26.9%）. It was signifi cantly associated with mean age and tumor size. Conclusion Clinicopathological results indicate that coexistence of PTMC with HT is more common in female, younger patients and characterized by higher TSH values. Moreover, in the patients of younger age or tumor size≥7.0 mm, cervical lymph node metastasis occurs more frequently.