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目的分析桥本甲状腺炎并发甲状腺乳头状癌的临床特征、诊断、治疗及预后情况。方法回顾性分析1998年6月至2005年10月经病理证实为桥本甲状腺炎并发甲状腺乳头状癌40例,对其甲状腺功能指标、诊断及手术治疗进行分析。结果桥本甲状腺炎并发甲状腺乳头状癌占同期291例经病理证实为桥本甲状腺炎的13.8%(40/291)。40例中7例发生淋巴结转移(7/40),随访发现对侧甲状腺乳头状癌1例,经再次手术无复发,其中7例病人随访5年以上,至今均存活。结论桥本甲状腺炎并发甲状腺乳头状癌的发生率呈上升趋势;对于合并自身甲状腺抗体阳性的中青年女性桥本甲状腺炎病人,甲状腺不规则结节性肿大发生癌变的发生率大于弥漫肿大者;桥本甲状腺炎并甲状腺乳头状癌淋巴结转移率低,总体预后好。
Objective To analyze the clinical features, diagnosis, treatment and prognosis of Hashimoto’s thyroiditis complicated with thyroid papillary carcinoma. Methods A retrospective analysis of 40 patients with Hashimoto’s thyroiditis complicated with thyroid papillary carcinoma confirmed by pathology from June 1998 to October 2005 was performed. Thyroid function indexes, diagnosis and surgical treatment were analyzed. Results Hashimoto’s thyroiditis complicated with thyroid papillary carcinoma accounted for 13.8% (40/291) of 291 cases of Hashimoto’s thyroiditis confirmed by pathology during the same period. Of 40 cases, 7 cases had lymph node metastasis (7/40). One case of papillary thyroid papillary carcinoma was followed up. No recurrence was found after surgery. Seven cases were followed up for more than 5 years and survived so far. Conclusions The incidence of thyroid papillary thyroid carcinoma in Hashimoto’s thyroiditis is on the rise. For patients with Hashimoto’s thyroiditis who have positive thyroid antibodies, the incidence of malignant thyroid irregular nodular enlargement is larger than that of diffuse enlargement Hashimoto’s thyroiditis and papillary thyroid lymph node metastasis rate is low, the overall prognosis is good.