合并甲状腺癌的多原发性癌的临床及病理特征分析

Clinical and pathological features of multiple primary malignancies involving thyroid cancer

目的:分析合并甲状腺癌的多原发性癌患者的临床及病理特征。方法:回顾性分析2007年10月至2017年3月云南省肿瘤医院确诊的4 861例甲状腺癌患者,从中筛选出290例(5.97%)合并其他恶性肿瘤的多原发癌患者,分析其临床及病理特征。结果:筛选出290例甲状腺癌患者,其中7例(2.4%)为三原发性恶性肿瘤,283例(97.6%)为双原发性恶性肿瘤。以肿瘤发生时间分类:83例(28.6%)为同时性多原发性癌,207例(71.4%)为异时性多原发性癌。248例(85.5%)患者以其他恶性肿瘤为首发,甲状腺癌为后发现。本研究以女性256例(88.3%)、年龄≥45岁191例(65.9%)、甲状腺乳头状癌281例(96.9%)多见。甲状腺癌最常合并的原发癌是乳腺癌44.5%(129/290),其次是宫颈癌、肺癌、结直肠癌等。结论:年龄≥45岁女性恶性肿瘤患者,尤其是乳腺癌患者,在随访复查过程中建议进行甲状腺癌筛查。

Objective:To analyze the clinical and pathological features of multiple primary malignancies involving thyroid cancer.Methods:A retrospective study of 4,861 thyroid cancer cases was performed.All patients were diagnosed at Yunnan Cancer Hospital between October 2007 and March 2017;among them,290 patients harbored multiple primary malignancies involving thyroid cancer.Their clinical and pathological features were analyzed.Results:Among the 290 patients with multiple primary malignancies involving thyroid cancer,7(2.4%)had three malignancies and 283(97.6%)had two malignancies.Eighty-three cases(28.6%)were synchronous multiple primary malignancies,and 207 cases(71.4%)were metachronous ones.Two hundred and forty-eight patients(85.5%)were primarily diagnosed with non-thyroid primary malignancies,and 42 patients(14.5%)had thyroid cancer as their primary diagnosis.Among 290 patients with multiple primary malignancies involving thyroid cancer,women(256,88.3%),age≥45 years(191,65.9%),and presence of papillary thyroid carcinoma(281,96.9%)were more common characteristics.Breast cancer was the most frequent accompanying disease(129,44.5%),followed by cervical cancer(47,16.2%),lung cancer(28,9.7%),and colon cancer(17,5.9%).Conclusions:Female cancer patients aged≥45 years,especially those with breast cancer,should undergo thyroid disease screening during their follow-up period.