甲状腺癌合并甲状腺功能亢进症病例的临床特征分析

Analysis of clinical characteristics of hyperthyroidism complicated with thyroid carcinoma

目的 系统研究甲状腺癌合并甲状腺功能亢进症的临床特点,并探讨甲状腺功能亢进症对甲状腺癌的形成、进展以及对患者预后的影响。方法 回顾性选取2015年1月至2017年3月广州市番禺中心医院收治的152例甲状腺癌手术患者作为研究对象,按照是否合并甲状腺功能亢进症分为对照组(122例)和甲亢组(30例),两组患者均进行手术治疗及术后随访,比较两组患者的相关临床及随访数据。结果 两组患者的年龄、性别、住院数据(手术时长、术中出血、住院天数)、肿瘤直径等指标比较,差异无统计学意义(P>0.05);甲亢组的淋巴转移、多病灶发生率和暂时性的甲状旁腺功能下降等发病率均高于对照组,差异有统计学意义(P<0.05);甲亢组术后3年内的无病生存率低于对照组,差异有统计学意义(P<0.05)。结论 甲状腺癌患者合并甲状腺功能亢进症,不利于治疗预后。甲状腺功能亢进症患者若发现存在怀疑恶性结节,需采取积极诊治手段。对于甲状腺功能亢进症合并甲状腺癌患者,可考虑选择更积极的治疗及手术方式,同时在术后做好血钙水平监测及预防性处理。

Objective To analyze the clinical characteristics of hyperthyroidism complicated with thyroid carcinoma, and to explore the effect of hyperthyroidism on the occurrence, development and prognosis of thyroid cancer. Methods A total of152 surgical patients with thyroid cancer admitted to Guangzhou Panyu Central Hospital from January 2015 to March 2017were retrospectively selected as research objects, they were divided into control group(122 patients) and hyperthyroidism group(30 patients) according to whether hyperthyroidism was combined. Both groups underwent surgical treatment and postoperative follow-up. The clinical and pathological features and prognosis of the two groups were compared. Results There were no significant differences between the two groups in terms of age, gender, hospitalization data(operation duration,intraoperative bleeding, hospitalization days), tumor diameter and other indicators(P>0.05). The incidences of lymph node metastasis, multiple lesions and temporary decrease of parathyroid function in hyperthyroidism group were higher than those in control group, the differences were statistically significant(P<0.05). The disease-free survival rate in hyperthyroidism group within 3 years after operation was lower than that in control group, with statistically significant difference(P<0.05).Conclusion The combination of hyperthyroidism is not conducive to the improvement of the prognosis of thyroid cancer. If a suspected malignant nodule is found in patients with hyperthyroidism, active diagnosis and treatment should be taken. For patients with hyperthyroidism combined with thyroid cancer, more active treatment and operation methods can be considered, and blood calcium level monitoring and preventive treatment should be done well after the operation.