中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
7期
511-514
,共4页
陈诚%余宁康%龚进发%吴志浩%陈海珍%沈晓卉%陈曦%李宏为
陳誠%餘寧康%龔進髮%吳誌浩%陳海珍%瀋曉卉%陳晞%李宏為
진성%여저강%공진발%오지호%진해진%침효훼%진희%리굉위
甲状腺肿瘤%癌,乳头状%桥本病%外科手术
甲狀腺腫瘤%癌,乳頭狀%橋本病%外科手術
갑상선종류%암,유두상%교본병%외과수술
Thyroid neoplasms%Carcinoma,papillary%Hashimoto disease%Surgical procedures,operative
目的 研究桥本甲状腺炎(HT)合并甲状腺乳头状癌(PTC)患者的临床特征,并探讨外科治疗方案.方法 回顾性分析2009年1月至2010年12月间收治的首次手术的PTC患者资料128例,其中30例为HT合并PTC.结果 女性HT合并PTC发病率为男性的6.5倍.HT合并PTC中央组淋巴结转移率(46.7%)略高于单纯PTC者(39.4%).HT合并微小PTC的中央组淋巴结转移率(45.5%)明显高于单纯微小PTC者(16.7%).直径>1 cm的单纯PTC中央组淋巴结转移率(47.2%)明显高于单纯微小PTC者(16.7%).而多灶PTC的中央组淋巴结转移率(73.3%)明显高于单灶癌者(36%);HT合并多灶PTC的中央组淋巴结转移率(100%)明显高于单纯多灶PTC者(69.2%).结论 HT合并PTC多见于中年女性,易早期发生中央组淋巴结转移.全甲状腺切除并中央组淋巴结清扫是必要的治疗方法.
目的 研究橋本甲狀腺炎(HT)閤併甲狀腺乳頭狀癌(PTC)患者的臨床特徵,併探討外科治療方案.方法 迴顧性分析2009年1月至2010年12月間收治的首次手術的PTC患者資料128例,其中30例為HT閤併PTC.結果 女性HT閤併PTC髮病率為男性的6.5倍.HT閤併PTC中央組淋巴結轉移率(46.7%)略高于單純PTC者(39.4%).HT閤併微小PTC的中央組淋巴結轉移率(45.5%)明顯高于單純微小PTC者(16.7%).直徑>1 cm的單純PTC中央組淋巴結轉移率(47.2%)明顯高于單純微小PTC者(16.7%).而多竈PTC的中央組淋巴結轉移率(73.3%)明顯高于單竈癌者(36%);HT閤併多竈PTC的中央組淋巴結轉移率(100%)明顯高于單純多竈PTC者(69.2%).結論 HT閤併PTC多見于中年女性,易早期髮生中央組淋巴結轉移.全甲狀腺切除併中央組淋巴結清掃是必要的治療方法.
목적 연구교본갑상선염(HT)합병갑상선유두상암(PTC)환자적림상특정,병탐토외과치료방안.방법 회고성분석2009년1월지2010년12월간수치적수차수술적PTC환자자료128례,기중30례위HT합병PTC.결과 녀성HT합병PTC발병솔위남성적6.5배.HT합병PTC중앙조림파결전이솔(46.7%)략고우단순PTC자(39.4%).HT합병미소PTC적중앙조림파결전이솔(45.5%)명현고우단순미소PTC자(16.7%).직경>1 cm적단순PTC중앙조림파결전이솔(47.2%)명현고우단순미소PTC자(16.7%).이다조PTC적중앙조림파결전이솔(73.3%)명현고우단조암자(36%);HT합병다조PTC적중앙조림파결전이솔(100%)명현고우단순다조PTC자(69.2%).결론 HT합병PTC다견우중년녀성,역조기발생중앙조림파결전이.전갑상선절제병중앙조림파결청소시필요적치료방법.
Objective To investigate the clinicopathological features and surgical treatment for Hashimoto thyroiditis (HT)concomitant with thyroid papillary carcinoma(PTC).Methods The clinical data in 128 cases of PTC including 30 cases of HT concomitant with PTC treated surgically and diagnosis confirmed pathologically from Jan 2009 to Dec 2010 were retrospectively analyzed.Results The incidence of Hashimoto thyroiditis concomitant with thyroid papillary carcinoma was 6.5 times higher among women than men.Rates of central lymph node metastasis in PTC concomitant with HT and PTC without HT were 46.7% and 39.4%,respectively.Rates of central lymph node metastasis in micro-PTC concomitant with HT and micro-PTC without HT were 45.5% and 16.7%.Rates of central lymph node metastasis in PTC > 1 cm were 47.2%.Rates of central lymph node metastasis in multiple PTC concomitant with HT and multiple PTC without HT were 100% and 69.2%.Conclusions Coexistent HT with PTC is common in middle-aged women.Central lymph node metastasis of PTC concomitant with HT is frequently involved irrespective of tumor size.Total thyroidectomy combined with central lymph node dissection is a safe and necessary management for HT concomitant with PTC.