CAJ | 학술논문

目的：探讨桥本氏甲状腺炎（ HT）与甲状腺乳头状癌（ PTC）的发病情况及临床特征。方法回顾性分析2011年3月至2013年9月在我院行甲状腺全切或部分切除手术且经病理确诊的1983例患者的病例资料并进行分类，分析HT合并PTC的发病风险及HT患者中合并PTC与未合并者的年龄、性别分布。结果 HT中合并PTC的发病率为48?27％（98/203），高于非HT中的22?5％（400/1780），发病危险提高了3?22倍（95％CI：2?39～4?33，P＝0?000）；HT合并PTC患者的年龄范围为17～72岁，在≤20、21～40、41～60和＞60岁的分布比例分别为2?0％（2/98）、44?9％（44/98）、48?9％（48/98）和4?0％（4/98）；400例未合并PTC的HT患者年龄范围13～79岁，各年龄段分布比例依次为1?8％（7/400）、31?8％（127/400）、52?5％（210/400）和14?0％（56/400），两部分患者年龄分布的差异有统计学意义（χ2＝10?615，P＝0?014）；HT合并PTC患者的男女比例为1∶15?3，低于未合并PTC的HT患者的1∶3，差异有统计学意义（χ2＝15?315，P＝0?000）。结论 HT与PTC可能存在一定的相关性，合并HT较不合并者发生PTC的风险明显增高且患癌年龄提前，患有HT者尤其是女性需及早预防PTC的发生。
목적：탐토교본씨갑상선염（ HT）여갑상선유두상암（ PTC）적발병정황급림상특정。방법회고성분석2011년3월지2013년9월재아원행갑상선전절혹부분절제수술차경병리학진적1983례환자적병례자료병진행분류，분석HT합병PTC적발병풍험급HT환자중합병PTC여미합병자적년령、성별분포。결과 HT중합병PTC적발병솔위48?27％（98/203），고우비HT중적22?5％（400/1780），발병위험제고료3?22배（95％CI：2?39～4?33，P＝0?000）；HT합병PTC환자적년령범위위17～72세，재≤20、21～40、41～60화＞60세적분포비례분별위2?0％（2/98）、44?9％（44/98）、48?9％（48/98）화4?0％（4/98）；400례미합병PTC적HT환자년령범위13～79세，각년령단분포비례의차위1?8％（7/400）、31?8％（127/400）、52?5％（210/400）화14?0％（56/400），량부분환자년령분포적차이유통계학의의（χ2＝10?615，P＝0?014）；HT합병PTC환자적남녀비례위1∶15?3，저우미합병PTC적HT환자적1∶3，차이유통계학의의（χ2＝15?315，P＝0?000）。결론 HT여PTC가능존재일정적상관성，합병HT교불합병자발생PTC적풍험명현증고차환암년령제전，환유HT자우기시녀성수급조예방PTC적발생。
Objective To determine the incidence and presentation of Hashimotos thyroiditis ( HT ) and papillary thyroid carcinoma ( PTC) . Methods In a retrospective study, 1983 patients undergoing partial or total thyroidectomy in our hospital from March 2011 to September 2013 were collected. All cases were confirmed by pathological examination and classified accordingly. Age and sex distribution of patients with HT and PTC were also discussed. Results The rate of PTC in patients with HT was 48.27%, higher than that in patients without HT with a 3.22-fold increase in risk (95%CI:2.39-4.33, P=0.000). The age of PTC patients with HT range form 17 to 72 and the percentage distributions of four classes of age (≤20, 21-40, 41-60 and >60 years) were 2.0%(2/98), 44.9%(44/98), 48.9%(48/98) and 4.0%(4/98), respectively. However, the age of PTC patients without HT range form 13 to 79 and the percentage distributions of four classes of age (≤20, 21-40, 41-60 and >60 years) were 1.8%(7/400), 31.8%( 127/400) , 52.5%( 210/400) and 14.0%( 56/400) , respectively. Significant difference was observed on the age distribution of the two groups (χ2=10.615, P=0.014) . The male-to-female sex ratio of PTC patients with HT was 1∶15.3, lower than that of PTC pa-tients without HT with statistical significance (χ2=15.315, P=0.000) . Conclusion HT exposure may be an inducing factor for PTC and could lead early occurrence of the disease. Middle-aged women with HT should take preventive measures in advance especially.