桥本甲状腺炎合并甲状腺乳头状癌的临床及病理学特征

Clinicopathologic features of Hashimoto's thyroiditis complicated with papillary thyroid cancer

目的分析桥本甲状腺炎（HT）合并甲状腺乳头状癌（PTC）的临床及病理学特征。方法 2013年10月至2015年10月共收治PTC患者297例。其中PTC合并HT者49例为研究组,男5例,女44例,24~67岁,〈45岁者27例。单纯PTC者248例为对照组,其中男60例,女188例,17~76岁,〈45岁者97例。分析两组患者的临床资料,包括性别、年龄、甲状腺弥漫性肿大、血清自身免疫抗体水平、是否存在包膜侵犯、肿瘤大小、术中冰冻病理准确率、中央区淋巴结转移、TNM分期,并行统计学分析。结果与对照组比较,研究组在性别、年龄、甲状腺弥漫性肿大、血清自身免疫抗体水平、中央区淋巴结转移方面差异均有统计学意义（P均〈0.05）,而是否存在包膜侵犯、肿瘤大小、术中快速病理、TNM分期差异无统计学意义（P〉0.05）。结论 HT合并PTC多见于女性,发病年龄较早,可伴有甲状腺弥漫性肿大及血清自身免疫抗体的升高,早期即可出现淋巴结转移。提示对HT患者应定期复查,以利其早期病变的诊疗。

Objective To analyze the clinicopathologic features of Hashimoto＇s thyroiditis（ HT） complicated with papillary thyroid cancer（ PTC）. Methods A total of 297 patients with PTC treated surgically during Oct. 2013 and Oct.2015 were divided into 2 groups： experimental group（ PTC complicated with HT,n = 49,5 males and 44 females,aged 24-67 years,27 cases 45 years）,and control group（ PTC only,n = 248,60 males and 188 females,aged 17-76 years,97 cases 45 years）. The clinical data of the 2 groups were compared and analyzed statistically,including gender,age,diffusely enlarged thyroid gland,level of serum autoimmune antibody,capsular invasion,tumor size,intraoperative frozen pathology,and TNMstaging. Results There were statistically significant differences between the 2groups in gender,age,diffusely enlarged thyroid gland,level of serum autoimmune antibody and central lymph node metastasis（ all P〈0. 05）,but no statistical differences in capsular invasion,tumor size,intraoperative frozen pathology and TNMstaging（ all P〉0. 05）. Conclusion HT complicated with PTC is more common in female patients,especially young women. It usually manifests as diffusely enlarged thyroid,increased serum autoimmune antibody and early lymph node metastasis. HT patients should check regularly for timely diagnosis and treatment.