CAJ | 학술논문

目的探讨原发性甲状腺功能亢进症(简称甲亢)合并甲状腺癌(简称甲癌)的流行病学及临床特点.方法回顾性分析2002年1月至2011年6月中南大学湘雅医院普外科手术治疗的365例甲亢中30例合并甲癌(甲亢并甲癌组)的临床资料,并与同一时段随机抽取的30例无甲亢的甲癌(对照组)对照分析.结果甲亢中甲癌发生率为8.22％ (30/365)；甲亢并甲癌组与对照组的病程中位数分别为875.00 d和120.00 d(z=-2.501,P＜0.05)；甲亢并甲癌组、对照组术前甲癌诊断率分别为40.0％(12/30)和66.7％(20/30)(x2 =4.286,P＜0.05)；甲亢并甲癌组、对照组淋巴结转移率分别为20.0％(6/30)和46.7％(14/30)(x2 =4.800,P＜0.05).本组均获随访,平均随访4.5年(1个月～9年半),甲亢并甲癌组1例(3.3％)术后5年甲亢复发,对照组1例(3.3％)术后1年甲癌复发再次手术切除,1例(3.3％)术后半年死于甲癌肺转移呼吸衰竭.结论原发性甲亢合并甲癌具有甲亢中甲癌发生率高、病程长、术前误诊率高、淋巴结转移率低、预后良好等特点.
목적 탐토원발성갑상선공능항진증(간칭갑항)합병갑상선암(간칭갑암)적류행병학급림상특점.방법 회고성분석2002년1월지2011년6월중남대학상아의원보외과수술치료적365례갑항중30례합병갑암(갑항병갑암조)적림상자료,병여동일시단수궤추취적30례무갑항적갑암(대조조)대조분석.결과 갑항중갑암발생솔위8.22％ (30/365)；갑항병갑암조여대조조적병정중위수분별위875.00 d화120.00 d(z=-2.501,P＜0.05)；갑항병갑암조、대조조술전갑암진단솔분별위40.0％(12/30)화66.7％(20/30)(x2 =4.286,P＜0.05)；갑항병갑암조、대조조림파결전이솔분별위20.0％(6/30)화46.7％(14/30)(x2 =4.800,P＜0.05).본조균획수방,평균수방4.5년(1개월～9년반),갑항병갑암조1례(3.3％)술후5년갑항복발,대조조1례(3.3％)술후1년갑암복발재차수술절제,1례(3.3％)술후반년사우갑암폐전이호흡쇠갈.결론 원발성갑항합병갑암구유갑항중갑암발생솔고、병정장、술전오진솔고、림파결전이솔저、예후량호등특점.
Objective To study the epidemiological and clinical features of primary hyperthyroidism complicated with thyroid cancer.Methods Clinical data of 30 cases of hyperthyroidism complicated with thyroid cancer(hyperparathyroidism group)were retrospectively analyzed.They were chosen from the 365 cases of primary hyperparathyroidism treated by operation from Jan.2002 to Jun.2011.At the same time,30 cases of thyroid cancer without hyperparathyroidism were randomly taken out as the control group.Results The incidence of thyroid cancer in primary hyperparathyroidism was 8.22％ (30/365).The median course,preoperative diagnostic rate of thyroid cancer,and lymph nodes metastasis rate for hyperparathyroidism group and control group was 875.00 vs 120.00 days(z =-2.501,P ＜0.05),40.0％ (12/30) vs 66.7％ (20/30) (x2 =4.286,P ＜0.05),and 20.0％ (6/30) vs 46.7％ (14/30) (x2 =4.800,P ＜ 0.05) respectively.All patients were followed up with the average of 4.5 years,ranging from 1 month to 9 yeas and a half.1 case(3.3％)in hyperparathyroidism group recurred hyperthyroidism 5 years after surgery.1 case(3.3％)recurred thyroid cancer 1 year after surgery and received operation again,and 1 case(3.3％)died half a year after operation from respiratory failure caused by lung metastasis of thyroid cancer in the control group.Conclusions Hyperthyroidism complicated with thyroid cancer has the characteristics of high incidence rate of thyroid cancer in the hyperthyroidism patients,long course,high preoperative misdiagnosis rate,low lymph node metastasis rate,favorable prognosis and so on.