桥本甲状腺炎与非桥本甲状腺炎合并甲状腺癌患者临床特征的比较

Comparison of the clinical characteristics between thyroid cancer patients with Hashimoto thyroiditis and non-Hashimoto thyroiditis

目的比较桥本甲状腺炎(HD)与非HD合并甲状腺癌患者的临床特征。方法回顾性分析70例HD合并甲状腺癌患者(观察组)和209例非HD合并甲状腺癌患者(对照组)的临床资料,比较两组患者的超声特征、甲状腺功能指标及病理结果。结果观察组患者中女性的比例高于对照组,差异有统计学意义(P﹤0.05)。观察组患者的血清促甲状腺素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。彩超检查结果显示,对照组患者小钙化的比例较高(46.41%),观察组患者无钙化的比例较高(47.14%),两组患者的钙化情况比较,差异有统计学意义(P﹤0.05);观察组患者边界不清晰的比例为85.71%,高于对照组的72.73%,差异有统计学意义(P﹤0.05)。病理结果显示,观察组患者无结节性甲状腺肿的比例为90.00%,明显高于对照组的73.21%,差异有统计学意义(P﹤0.01)。结论 HD合并甲状腺癌的发病年龄较早,多见于女性,超声检查多表现为边界不清晰和无钙化,以上特征有助于鉴别HD合并甲状腺癌和非HD合并甲状腺癌。

Objective To compare the clinical characteristics of patients with thyroid cancer combined with Hashimo- to thyroiditis （HD） or non-Hashimoto thyroiditis （non-HD）. Method The clinical data of 70 cases with HD and thyroid cancer （study group）, and 209 cases with non-HD and thyroid cancer （control group） were retrospectively analyzed, the ul- trasound characteristics, functional measures of thyroid as welt as the pathological findings of the two groups were com- pared. Result More females were in study group than in control group, with statistically significant difference observed （P〈0.05）. The levels of TSH, TGAb and TPOAb in serum of patients in study group were significantly higher than those in control group （P〈0.01）. In regard of color Doppler ultrasound results, higher rate of microcalcification in control group （46.41%） was observed, and there were more patients with no calcification in study group （47.14%）, the difference was of statistical significance （P〈0.05）; in study group, poorly-defined margin were observed in 85.71% patients, which was higher than the 72.73% in control group, showing statistically significant difference （P〈0.05）. Pathological findings showed that, the proportion of patients with non-nodular goiter was 90.00%, which was higher than that of 73.21% in con- trol group, with statistically significant difference observed （P〈0.01）. Conclusion HD combined with thyroid cancer de- velops in early age, and is more common in females, in ultrasound examinations, it is often with unclear thyroid margin, while few microcalcification were observed, which is helpful to improve the differential diagnosis of HD and non-HD complicated with thyroid cancer.