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目的:探讨桥本甲状腺炎(HT)与甲状腺乳头状癌(PTC)之间的关系。方法:回顾性分析2010年1月—2015年5月495例接受手术治疗,术后病理诊断为PTC的患者资料,比较伴有和不伴有HT患者的临床病理特点。结果:495例PTC患者中,伴发HT者108例(21.81%)。单因素分析结果显示,与单纯PTC患者比较,PTC并HT患者中女性多见(90.7% vs.71.6%)、术前促甲状腺激素(TSH)水平(4.04 μIU/mL vs.2.76 μIU/mL)及甲状腺过氧化物酶抗体(TPOAb)水平偏高(94.31 IU/mL vs.33.65 IU/mL)、肿瘤最大径偏小(1.10 cm vs.1.31 cm)、临床分期偏早(I期87.1% vs.76.8%),差异均有统计学意义(均P<0.05)。Logistic回归分析显示,患者的性别、TSH水平、TPOAb水平、临床分期是PTC合并HT的独立预测因素(均P<0.05)。结论:PTC合并HT患者中,女性较多,临床分期较早,并且肿瘤偏小,提示合并HT并未增加PTC的侵袭性,预后较好。但合并HT的患者TSH水平偏高,提示HT可能是PTC的发病风险因素之一。
Objective: To investigate the relationship between Hashimoto’s thyroiditis (HT) and papillary thyroid carcinoma (PTC). Methods: A retrospective analysis of 495 patients who underwent surgery between January 2010 and May 2015 was performed. The pathologic data of patients with PTC were analyzed retrospectively. The clinicopathological features of patients with or without HT were compared. Results: Among 495 PTC patients, 108 cases (21.81%) had HT. Univariate analysis showed that more women were PTC (90.7% vs.71.6%), TSH (4.04 μIU / mL vs.2.76 μIU / mL) (94.31 IU / mL vs.33.65 IU / mL). The largest diameter of tumor was smaller (1.10 cm vs.1.31 cm), the clinical stage was earlier (87.1% vs .76.8%), the differences were statistically significant (all P <0.05). Logistic regression analysis showed that gender, TSH level, TPOAb level and clinical stage were independent predictors of PTC combined with HT (all P <0.05). Conclusion: There are more women, clinical stages and earlier tumors in PTC patients with HT, suggesting that the combined HT does not increase the invasiveness of PTC and the prognosis is good. TSH levels in patients with HT are high, suggesting that HT may be one of the risk factors of PTC.