CAJ | 학술논문

目的探讨甲状腺嗜酸细胞肿瘤的临床特点和治疗效果.方法回顾性分析天津医科大学附属肿瘤医院头颈外科2001-2009年收治的28例甲状腺嗜酸细胞肿瘤患者临床资料.结果患者中男6例,女22例;年龄18～72岁,中位年龄46.5岁.22例临床表现为甲状腺单发结节或肿块,6例表现为甲状腺多发结节.行单侧甲状腺腺叶切除11例,单侧甲状腺腺叶+峡部切除11例,甲状腺近全切除术4例,2例行腺叶+峡部切除及颈清扫术.术后病理:甲状腺嗜酸细胞腺瘤22例,嗜酸细胞癌6例,其中1例有颈淋巴转移.21例良性患者获得随访,随访时间6个月至7.5年,中位随访45个月,均未发现肿瘤复发;6例恶性患者均获得随访,随访时间3～8年,中位随访54个月,均未发现肿瘤复发或转移.结论甲状腺嗜酸细胞肿瘤诊断依赖于病理学,部分病例有恶性可能,冰冻诊断有一定困难.手术是治疗嗜酸细胞肿瘤的有效手段.左旋甲状腺素片可起到抑制促甲状腺激素分泌的作用.
목적 탐토갑상선기산세포종류적림상특점화치료효과.방법 회고성분석천진의과대학부속종류의원두경외과2001-2009년수치적28례갑상선기산세포종류환자림상자료.결과 환자중남6례,녀22례;년령18～72세,중위년령46.5세.22례림상표현위갑상선단발결절혹종괴,6례표현위갑상선다발결절.행단측갑상선선협절제11례,단측갑상선선협+협부절제11례,갑상선근전절제술4례,2례행선협+협부절제급경청소술.술후병리:갑상선기산세포선류22례,기산세포암6례,기중1례유경림파전이.21례량성환자획득수방,수방시간6개월지7.5년,중위수방45개월,균미발현종류복발;6례악성환자균획득수방,수방시간3～8년,중위수방54개월,균미발현종류복발혹전이.결론 갑상선기산세포종류진단의뢰우병이학,부분병례유악성가능,빙동진단유일정곤난.수술시치료기산세포종류적유효수단.좌선갑상선소편가기도억제촉갑상선격소분비적작용.
Objective To explore the clinical features and the combined treatment modality of Hurthle cell thyroid tumor(HCT). Methods Twenty-eight cases of HCT treated between 2001 and 2009were analyzed retrospectively. Results The age of the patients ranged from 18 to 72 years (with a median of 46.5 years); 22 females and 6 males. The main symptoms were thyroid solitary node or mass(22 cases)and multiple nodule(6 cases), 2 cases with cervical lymph node metastasis. All of the patients underwent surgery, 11 cases with thyroid lobectomy, 11 cases with thyroid lobectomy plus isthmusectomy, 4 cases with subtotal thyroidectomy, and 2 cases with thyroid lobectomy plus isthmusectomy and combined with modified radical cervical lymph node dissection. Postoperative pathological examination showed that 22 cases were Hurthle cell adenomas and 6 cases were Hurthle cell carcinomas, 1 of them with cervical lymph nodemetastasis. Twenty-one patients with Hurthle cell adenomas were followed up for 6 months to 7.5 years (with a median of 45 months) and 6 patients with Hurthle cell carcinomas for 3 to 8 years (with a median of 54 months), with no recurrence and death case. Conclusions HCT is a potential malignant neoplasm.There are some difficulties in the diagnosis of HCT by frozen section. Surgery is an effective treatment for HCT. L-Thyroxine can be used to inhibit TSH excretion.