桥本甲状腺炎合并甲状腺乳头状癌的临床诊治

目的 探讨桥本甲状腺炎（HT）合并甲状腺乳头状癌（PTC）的临床诊治特点。方法 回顾性分析60例HT合并PTC的临床资料。结果 甲状腺功能检查60例中48例甲状腺球蛋白抗体（TgAb）或甲状腺过氧化物酶抗体（TPOAb）升高;B超检查60例均发现甲状腺存在实质性肿块,其中钙化灶25例,占41.67%,颈部肿大淋巴结15例（2例疑为癌转移）;5例行甲状腺细针穿刺（FNA）,疑癌细胞4例,高度疑恶性者1例。术后随访6个月-10年,3例术后2-5年死于肺及骨转移,其余无复发及转移。结论 术前诊断HT合并PTC包括TgAb、TPOAg、B超检查及FNA。HT合并PTC手术治疗是最有效的方法,手术治疗效果好,预后好。

Objective To investigate Hashimoto＇s thyroiditis （HT） with thyroid papillary carcinoma （PTC） in the clinical characteristics of diagnosis and treatment. Methods The clinical data of 60 cases of HT with PTC were retrospectively analyzed. Results Thyroid function tests in 60 patients with 48 cases of thyroid globulin antibody （TgAb） or thyroid peroxidase antibody （TPOAb） were increased; 60 cases were found to have a substantial tumor, including 25 cases of calcifcation, 15 cases of cervical lymph nodes enlarged （2 cases suspected of cancer metastasis）; 5 cases of thyroid fne needle aspiration （FNA）, 4 cases of suspected cancer, 1 cases of highly suspected malignant. Follow up 6 months to 10 years, 3 cases died of lung and bone metastasis in cases, and the rest had no recurrence and metastasis. Conclusion HT with PTC, TPOAg, TgAb, and FNA were important in the preoperative diagnosis of HT. Surgery for HT with PTC is the most effective method in treatment, the effect is good, and the prognosis is good.