桥本氏甲状腺炎合并甲状腺乳头状癌临床特征的研究

摘要

目的 探讨桥本氏甲状腺炎合并甲状腺乳头状癌时的临床特点.方法 回顾性分析郑州大学第一附属医院甲状腺外科2008至2009间收治的桥本氏甲状腺炎合并甲状腺乳头状癌病例59例及单纯甲状腺乳头状癌病例179例.结果 桥本氏甲状腺炎合并甲状腺乳头状癌时微小癌比例增高(35.6％对比19.0％,P=0.009),中央区淋巴结转移率降低(72.9％对比55.9％,P=0.021),颈侧区淋巴转移率未降低(6.8％对比2.2％,P=0.107).结论 桥本氏甲状腺炎合并甲状腺乳头状癌的预后可能好于单纯甲状腺乳头状癌.桥本氏甲状腺炎合并甲状腺乳头状癌时,因中央区淋巴结转移率降低,预防性中央区淋巴结清扫收益将会减少.桥本氏甲状腺炎合并甲状腺乳头状癌患者颈侧区淋巴结转移风险未降低.%Objective To investigate the clinical characteristics and treatment of patients with Hashimoto's disease combined with papillary thyroid carcinoma (PTC).Methods A restrospective analysis of 59 cases of PTC combined with Hashimoto' s disease and 179 cases of PTC without Hashimoto's disease were made.Results There were higher rate of microcarcinoma (35.6％ vs 19.0％,P =0.009),lower metastasis rate of central area(72.9％ vs 55.9％,P =0.021) and equal risk of lateral neck metastasis(6.8％ vs 2.2％,P =0.107) in patients with PTC combined with Hashimoto' s disease.Conclusions PTC combined with Hashimoto' s disease may have better prognosis than PTC without Hashimoto' s disease.The benefit of prophylactic central area dissection was compromised in PTC combined with Hashimoto' s disease because of lower metastasis proportion in central compartment.There was equal risk of lateral lymph metastasis in PTC combined with Hashimoto's disease and PTC without Hashimoto's disease.