CAJ | 학술논문

目的探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)合并桥本甲状腺炎(Hashimoto's thyroiditis,HT)的临床生物学特性.方法回顾性分析天津医科大学附属肿瘤医院甲状腺颈部肿瘤科2011年1-10月所收治的具有完整临床病理资料的PTC初治患者445例的临床资料,其中97例合并HT.结果 PTC合并HT组女性发病比例、多灶病变发生比例高于单纯PTC组(P＜0.05).两组在年龄、肿瘤直径、腺外侵犯、淋巴结转移、TNM分期之间的差异无统计学意义.PTC合并HT组术前血清FT3、FT4水平低于单纯PTC组,而TSH水平、甲状腺自身抗体Anti-TG和Anti-TPO水平高于单纯PTC组(P＜0.05).对本组134例PTC患者癌灶进行BRAFV600E基因突变检测,PTC合并HT组BRAFV600E基因突变率为35.3％,单纯PTC组突变率为64.0％,差异有统计学意义(P＜0.01).结论 PTC合并HT中女性发病比例、多灶病变的发生比例高于单纯PTC；HT患者血清TSH水平升高可能与PTC的发生有关；PTC合并HT组BRAFV600E基因突变率较单纯PTC组低.
목적 탐토갑상선유두상암(papillary thyroid carcinoma,PTC)합병교본갑상선염(Hashimoto's thyroiditis,HT)적림상생물학특성.방법 회고성분석천진의과대학부속종류의원갑상선경부종류과2011년1-10월소수치적구유완정림상병리자료적PTC초치환자445례적림상자료,기중97례합병HT.결과 PTC합병HT조녀성발병비례、다조병변발생비례고우단순PTC조(P＜0.05).량조재년령、종류직경、선외침범、림파결전이、TNM분기지간적차이무통계학의의.PTC합병HT조술전혈청FT3、FT4수평저우단순PTC조,이TSH수평、갑상선자신항체Anti-TG화Anti-TPO수평고우단순PTC조(P＜0.05).대본조134례PTC환자암조진행BRAFV600E기인돌변검측,PTC합병HT조BRAFV600E기인돌변솔위35.3％,단순PTC조돌변솔위64.0％,차이유통계학의의(P＜0.01).결론 PTC합병HT중녀성발병비례、다조병변적발생비례고우단순PTC；HT환자혈청TSH수평승고가능여PTC적발생유관；PTC합병HT조BRAFV600E기인돌변솔교단순PTC조저.
Objective To analyze the clinical and biological characteristics of papillary thyroid carcinoma(PTC) associated with Hashimoto's thyroiditis(HT).Methods From January 2011 to October 2011,clinical data of 445 PTC patients (97 coexisting with HT) treated at Department of Thyroid and Neck Tumor,Tianjin Medical University Cancer Hospital were retrospectively analyzed.Results In PTC patients coexisting with HT,as compared with those PTC without HT,there were more women patients and more cases with intrathyroid multifocal lesions (all P ＜ 0.05).There were no differences in age,tumor size,extrathyroid extension,lymph node metastasis and TNM stage between the 2 groups.There were lower levels of preoperative serum FT3 and FT4,higher levels of TSH,Anti-TG and Anti-TPO in the HT group (P ＜0.05).Tumor samples of 134 patients was examined for the BRAFV600E mutation.The frequency of BRAFV600E mutation in HT group was lower than that in the papillary thyroid carcinoma group without HT (35.3％ vs.64.0％,P ＜0.01).Conclusions There were more women in papillary thyroid carcinoma coexisting HT group,and multifocal lesions were more common.The high serum TSH levels may be associated with the occurrence of papillary thyroid carcinoma in some HT patients.The frequency of BRAFV600E mutation in the HT group was lower than that in the papillary thyroid carcinoma group without HT.