慢性淋巴细胞性甲状腺炎合并甲状腺乳头状癌的外科诊疗

Diagnosis and treatment ofchronic lymphocytic thyroiditis combined with papillary thyroid cancer

目的探讨慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺乳头状癌(PTC)的临床诊断及治疗。方法回顾性分析2014年8月至2016年6月安徽医科大学第二附属医院收治的36例CLT合并PTC患者的临床资料。结果 36例患者中,有22例(61. 1%)存在多发结节,21例(58. 3%)位于双侧; 9例(25. 0%)存在多发癌灶,4例(11. 1%)位于双侧。32例患者行中央区或联合颈侧区淋巴结清扫术,17例(53. 1%)存在中央区转移淋巴结。结论 CLT合并的PTC有多灶性特点,手术方式建议行甲状腺全/近全切除术,少数患者可行单侧腺叶+峡部切除;建议常规清扫中央区淋巴结,慎重选择清扫颈侧区淋巴结。

Objective To investigate the diagnosis and treatment of chronic lymphocytic thyroiditis（CLT） combined with papillary thyroid carcinoma（PTC）. Methods The clinical data of 36 patients diagnosed as CLT combined with PTC were retrospectively analyzed. Results Twenty - two（61.1 % ） of the 36 patients had multiple nodules, 21 （58.3% ） were bilateral; 9 （ 2 5 .0% ） were multiple cancer fo-ci, and 4（11.1%） were bilateral. Thirty - two patients underwent central or combined lateral cervical lymphadenectomy, and 17（53.1% ） had positive central lymph nodes. Conclusion The CLT combined PTC has multifocal characteristics. Total/near total thyroidectomy is rec-ommended. Unilateral lobectomy plus isthmus resection is feasible for some patients. The dissection of central lymph node dissection is rec-ommended ,and the selectionshould be carefulfor the lateral cervical lymph nodedissection.