甲状腺乳头状癌合并桥本甲状腺炎的临床病理特点
Clinical and pathological characteristics of papillary thyroid carcinoma complicated with Hashimoto's thyroiditis
王子澳 1吴瑞乔1
作者信息
- 1. 武汉科技大学附属天佑医院普通外科 湖北 武汉 430064
- 折叠
摘要
目的:探讨甲状腺乳头状癌(PTC)伴桥本甲状腺炎(HT)患者的临床病理特点、治疗及预后.方法:纳入2012年12月—2022年12月期间由武汉科技大学附属天佑医院收治经病理诊断为PTC伴有HT的患者共45例,将其作为合并组,同期随机选取60例单纯PTC的患者作为对照组,对两组的临床病理特点及预后进行比较.结果:合并组中女性占比64.44%,高于对照组(女性占比33.33%);术前促甲状腺激素(TSH)水平(1.96±0.33)μIU/mL高于对照组(1.53±0.35)μIU/mL,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平低于对照组,血清甲状腺球蛋白抗体(Tg-Ab)与血清甲状腺过氧化物酶抗体(TPO-Ab)升高率、术前彩超微小钙化灶检出率均高于对照组(P<0.05).两组的年龄、中央区及颈侧区淋巴结转移率、肿瘤病灶多发率、甲状腺包膜及腺外侵犯率、术后并发症及癌症复发率等方面均无明显差异(P>0.05).多因素分析发现,患者合并HT并非导致PTC中央区淋巴结转移的独立危险因素(P>0.05).结论:PTC合并HT更好发于女性,通常伴随甲状腺机能减退症,合并HT并不会使患者的术前、术中诊断难度增加,对此类患者采用常规手术进行治疗不会增加术后并发症和癌症复发风险.
Abstract
Objective:To investigate the clinical and pathological characteristics,treatment,and prognosis of patients with papillary thyroid carcinoma(PTC)accompanied by Hashimoto's thyroiditis(HT).Methods:A total of 45 patients diagnosed with PTC accompanied by HT and treated at Tianyou Hos-pital affiliated to Wuhan University of Science and Technology from December 2012 to December 2022 were included as the combined group,and 60 randomly selected patients with simple PTC dur-ing the same period were included as the control group.Results:The proportion of females in the com-bined group(64.44%)was higher than that in the control group(33.33%).The preoperative thyroid-stimulating hormone(TSH)level(1.96±0.33)μIU/mL was higher than that of the control group(1.53±0.35)μIU/mL,and the levels of free triiodothyronine(FT3)and free thyroxine(FT4)were lower.The serum thyroglobulin antibody(Tg-Ab)and thyroid peroxidase antibody(TPO-Ab)eleva-tion rates and the preoperative ultrasonographic detection rate of microcalcifications were higher in the combined group than in the control group,and the differences were statistically significant(P<0.05).There were no significant differences between the two groups in terms of age,central and lateral cervi-cal lymph node metastasis rates,multifocality of tumor lesions,thyroid capsule and extrathyroidal in-vasion rates,postoperative complications,and cancer recurrence rates(P>0.05).The multifactorial analysis found that the presence of HT was not an independent risk factor for central lymph node me-tastasis of PTC(P>0.05).Conclusion:PTC accompanied by HT is more common in females and is usually accompanied by hypothyroidism.The presence of HT does not increase the difficulty of preop-erative and intraoperative diagnosis in patients,and conventional surgery for such patients does not in-crease the risk of postoperative complications and cancer recurrence.
关键词
甲状腺乳头状癌/桥本甲状腺炎/临床特点/预后Key words
Papillary Thyroid Cancer/Hashimoto's Thyroiditis/Clinical Characteristics/Prog-nosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据