NG及HT合并甲状腺乳头状癌的临床病理分析

Clinicopathological features of papillary thyroid cancer complicated with nodular goiter or Hashimoto's thyroiditis

目的探讨结节性甲状腺肿(nodular goiter,NG)、桥本氏甲状腺炎(Hashimoto's thyroiditis,HT)合并甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的临床病理特征。方法回顾性分析270例甲状腺乳头状癌患者,筛选NG合并PTC(68例)、HT合并PTC(60例)及单纯PTC(104例)患者将其分成三组,分析其相关临床特征。结果与单纯PTC组比较,NG合并PTC患者中男性比率低、肿瘤直径小、多灶率低、双侧癌比率低、淋巴结转移率低、TGAb表达高和TPOAb表达低等,HT合并PTC患者中男性比率低、肿瘤直径小、多灶率高、双侧癌比率高、淋巴结转移率低、TGAb及TPOAb表达高等临床特征,差异均有统计学意义(均P<0.05)。结论 NG及HT合并甲状腺癌中男性患者较少,肿瘤直径小,淋巴结转移率低,HT合并PTC患者癌灶多灶率高和双侧癌比率较高。

Objective To compare the clinicopathological characteristics of papillary thyroid cancer（ PTC） complicated with nodular goiter（ NG） or Hashimoto＇s thyroiditis（ HT）. Methods The clinical data of 270 cases of PTC patients were retrospectively reviewed. Patients were categorized into three groups： PTC complicated with NG（ 68 cases）,PTC complicated with HT（ 60 cases）,PTC alone（ 104 cases）,and the clinical features were compared among three groups. Results Compared to PTC group,patients in PTC with NG group had lower male to female ratio,reduced tumor diameter,less multiple lesions and bilateral tumors,lower lymph node metastasis rate,higher TGAb and lower TPOAb levels（ all P〈0. 05）. Patients in PTC with HT group had lower male to female ratio,reduced tumor diameter,more multiple lesions and bilateral tunors,lower lymph node metastasis rates,higher TGAb and TPOAb levels,compared to PTC group（ all P〈0. 05）. Conclusion PTC complicated with HG or HT has different clinicopathological features,as compared to PTC alone. Multi-center collaboration and long-term follow-up are necessary for further study of these two types of papillary thyroid carcinoma.