甲状腺乳头状微小癌合并桥本病的临床病理研究

摘要

Objective To analyze the clinicopathologic differences in patients with papillary thyroid microcarcinoma( PTMC) with or without Hashimoto's thyroiditis( HT). Methods A total of 1315 PTMC patients who underwent thyroidectomy were reviewed. We compared the clinicopathologic features of PTMC patients with or without HT. Results The PTMC patients with HT had the significantly different following features as compared to patients without HT: age, gender, the level of preoperative TSH, microcalcifications detected by ultrasonography, multifocality and bilaterality of tumors( P < 0. 05 or P < 0. 01 ). Moreover, the Logistic regression analysis showed that the features of age,gender, the level of preoperative TSH, microcalcifications, multifocality of tumors were independent clinical factors in patients with HT compared to PTMC patients without HT( P < 0. 05 or P < 0. 01). Conclusion Compared to PTMC patients without HT, patients with HT have the features of younger age, female predominance, higher level of TSH, higher frequence of microcalcifications and multifocality of tumors. Clinicians should pay more attention to the diagnosis and treatment of PTMC with HT.%目的 探讨甲状腺乳头状微小癌(papillary thyroid microcarcinoma,PTMC)与桥本病(Hashimoto's thyroiditis,HT)的临床病理关系和特点.方法 采用回顾性对照研究的方法分析1315例PTMC患者,依据是否合并HT分成两组,比较其临床病理特点.结果 PTMC合并HT患者与未合并HT相比:在年龄、性别、术前TSH水平、B超检查肿瘤微小钙化、甲状腺癌多发灶及双侧甲状腺癌方面存在差异(P＜ 0.05或P＜0.01).Logistic回归分析提示:年龄、性别、肿瘤微小钙化率、术前TSH水平、甲状腺癌多发灶都是PTMC合并HT的独立临床因素(P＜0.05或P＜0.0).结论 合并HT的PTMC患者与发病年龄、性别、术前TSH水平和甲状腺癌多发灶显著相关,临床医师更应重视HT合并PTMC的早期诊断和治疗.