天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (11): 1311-1314.doi: 10.11958/20160150

• 内分泌专题 • 上一篇    下一篇

桥本甲状腺炎与甲状腺乳头状癌关系的临床研究

侯卫东 1， 王俊宏 1△， 张志宇 1， 刘艳晓 1， 李进 1， 禹远远 1， 田勇 1， 丁红霞 1， 刘艳峰 2   

  1. 1 河南省平顶山市第一人民医院内分泌代谢科 （邮编 467000）； 2 河南省平顶山市， 解放军 152 医院病理科
  • 收稿日期:2016-03-11 修回日期:2016-05-29 出版日期:2016-11-15 发布日期:2016-11-15
  • 通讯作者: △通讯作者 E-mail:hou_dm@126.com E-mail:hou_dm@126.com
  • 作者简介:侯卫东 （1981）， 男， 硕士， 主治医师， 主要从事内分泌代谢疾病的基础与临床研究

A retrospective clinical study on the relationship between Hashimoto’ s thyroiditis and papillary thyroid cancer

OU Weidong1, WANG Junhong1△, ZHANG Zhiyu1, LIU Yanxiao1, LI Jin1, YU Yuanyuan1, TIAN Yong1, DING Hongxia1, LIU Yanfeng2   

  1. 1 Division of Endocrinology, Pingdingshan Municipal First People’ s Hospital, Henan 467000， China; 2 Department of Pathology, People’ s Liberation Army 152 Hospital
  • Received:2016-03-11 Revised:2016-05-29 Published:2016-11-15 Online:2016-11-15
  • Contact: △Corresponding Author E-mail: hou_dm@126.com E-mail:hou_dm@126.com

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摘要： 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 收集 2000 年 1 月—2015 年 6 月 6 234 例甲状腺结节手术患者的临床资料， 术后经病理确诊为 PTC 1 016 例， 依据合并 HT 与否分为合并 HT 及未合并 HT 两组， 对其临床特征进行比较分析。结果 （1） 6 234 例患者中 8.66%合并 HT （540/6 234）。与未合并 HT 者相比， 合并 HT 者女性多见、 年龄更小、 PTC 检出率更高 （P < 0.01）。（2） 1 016 例 PTC 患者中， 与未合并 HT 者相比，合并 HT 者女性更多见、 平均年龄更小、 高发年龄 36～55 岁， 多发癌灶更常见、 微小癌 （≤1 cm） 比例更高， 原发灶包膜外侵犯比例、 淋巴结转移率、 TNM 分期Ⅲ/Ⅳ期比例及 BRAF 突变率更低 （P < 0.01 或 P < 0.05）。合并 HT 与 PTC 的发生呈正相关 （P < 0.01）。结论 HT 与 PTC 的发生呈正相关。PTC 合并 HT 患者女性更多见、 预后更好。

关键词: 桥本病, 甲状腺肿瘤, 癌, 乳头状, 甲状腺结节

Abstract: Objective To investigate the relationship of Hashimoto’ s thyroiditis (HT) and papillary thyroid cancer (PTC). Methods Clinical data of 6 234 patients with thyroid nodule operation were collected from January 2000 to June 2015. PTC was pathologically confirmed after operation in 1 016 cases. Patients were divided into PTC combined with HT group and PTC without HT group. The clinical features were compared and analyzed between two groups. Results (1) In 6 234 patients, 8.66% (540/6 234) patients were complicated with HT. Compared with patients without HT, there were more female patients, more younger patients and higher incidence of PTC in this group of patients. (P < 0.01). (2) In 1 016 patients with PTC, compared with patients without HT, there were more female patients combined with HT, more patients with lower average ages, and high incidence of age from 36 to 55 years old, multiple cancers were more common, higher proportion of small cancer (≤1 cm), and lower extracapsular extension ratio, lower rate of lymph node metastasis, and lower ratio of TNM stage Ⅲ/Ⅳ and lower BRAF mutation rate (P < 0.05 or P < 0.01). There was a positive correlation between the occurrence of HT and PTC (P < 0.01). Conclusion There is a positive correlation between the occurrence of HT and PTC. In patients combined with HT and PTC, there are more female ones, and whose prognosis are better.

Key words: Hashimoto disease, thyroid neoplasms, carcinoma, papillary, thyroid nodule