甲状腺肺转移癌的临床诊治分析

Clinical study on metastatic lung cancer to thyroid gland

目的分析并总结甲状腺肺转移癌的临床特点、诊治方式及预后。方法回顾性分析北京协和医院2001–2016年期间收治的15例甲状腺肺转移癌患者的临床资料。结果本组患者男5例,女10例,男女比例为1∶2。年龄36~79岁,平均59岁。4例患者以甲状腺转移癌为首发症状,其余11例从确诊原发肿瘤到发现甲状腺转移癌时间间隔为0~21个月,平均为4个月,其中有8例为同时发现原发灶与转移灶。15例患者中12例经细针穿刺活检或手术病理学检查证实。有3例患者接受手术治疗,5例接受化疗或放化疗,7例放弃治疗。随访截至2016年8月31日,有5例患者仍生存,其余均死亡,平均生存期为10个月。结论甲状腺肺转移癌少见,临床上需与原发性甲状腺癌相鉴别,细针穿刺活检可以有效诊断;甲状腺肺转移癌预后较差,不推荐手术治疗。

Objective To analyze and summarize clinical characteristics, diagnostic method, choice of treatment, and prognosis of metastatic lung cancer to thyroid gland. Method The clinical materials of the 15 patients presenting with secondary thyroid cancer were analyzed retrospectively. Results There were 10 females and 5 males in the 15 patients, with the female to male ratio of 2 ： 1. The age ranged from 36 to 79 years old with an average 59 years old. The diagnoses of 12 cases were made by the surgery or the fine needle aspiration biopsy （FNAB）, 3 cases by the clinic. The interval from the diagnosis of the primary tumor to the thyroid metastasis varied from 0 month to 21 months with an average 4 months. Three patients received the thyroidectomy, 5 patients received the chemotherapy or chemoradiotherapy, and 7 patients gave up the treatment. The average survival time was 10 months. Conclusions Metastatic lung cancer to thyroid gland is rare, and FNAB is a useful tool for diagnosis. Thyroidectomy may not be recommended because of poor prognosis.