甲状腺结节与其他实体瘤并存的临床诊治研究

发布时间：2018-03-06 22:16

本文选题：甲状腺结节　切入点：肿瘤　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景:现阶段,甲状腺结节的检出率不断上升,甲状腺癌现已成为目前最常见的恶性肿瘤之一。在临床工作中,一些实体肿瘤患者往往在诊治过程中意外发现甲状腺结节,且并存的甲状腺结节的恶性率可能较一般甲状腺结节高,临床上甲状腺结节与其他部位实体瘤并存的情况越来越常见,可能带来相应的诊断和鉴别诊断的诸多困难。然而,在中外文献中却几乎没有这样的论述。因此我们尝试对甲状腺结节与其他实体瘤并存的相关问题进行讨论,以期引起临床医生的重视。目的:调查实体肿瘤患者中甲状腺结节的发生率和恶性率,探讨甲状腺结节与原发恶性肿瘤的关系及对其诊治的影响。方法:收集安徽医科大学第二附属医院医院肿瘤中心2016年1月1日至2016年3月31日所有住院患者作为实体肿瘤组,进行甲状腺彩超、TSH测定检查,并与同时期性别、年龄相似的健康体检人群相比较。统计甲状腺结节的发生情况,分析其与实体肿瘤的关系及对诊治的影响。结果:2016年1月1日至2016年3月31日共收治294例患者,作为实体肿瘤组(男150人,女144人),平均年龄57.42±11.27岁(26-82岁),中位年龄60岁;同一时期体检中心接受甲状腺超声、甲状腺激素检查的体检人群共280人作为对照组(男140人,女140人),平均年龄54.25±10.78岁(28-80岁),中位年龄58岁。与对照组相比,实体肿瘤组中甲状腺结节的总体发病率及甲状腺多发结节发病率较高(p0.05),结节直径多在1cm以下。实体肿瘤组并存的甲状腺结节恶性率较高(23.53%),乳腺癌是并发甲状腺结节最多的实体肿瘤。甲状腺结节对实体肿瘤患者临床诊治无影响104例(65.00%),轻度影响46例(28.75%),中度影响6例(3.75%),重度影响4例(2.50%)。结论:实体肿瘤中并存的甲状腺结节发病率及恶性率均较高,在临床中应该受到重视。甲状腺结节对实体肿瘤诊治的影响与原发病的情况有关。全面检查甲状腺可能对病情复杂(尤其是原发灶不明淋巴结转移癌)的肿瘤诊治有很大帮助。
[Abstract]:Background: at present, the detection rate of thyroid nodules is increasing, thyroid cancer has become one of the most common malignant tumors. In clinical work, some patients with solid tumors often accidentally found thyroid nodules in the course of diagnosis and treatment. Moreover, the malignant rate of thyroid nodules with coexisting thyroid nodules may be higher than that of normal thyroid nodules, and the coexistence of thyroid nodules with other solid tumors is becoming more and more common in clinical practice, which may lead to many difficulties in the diagnosis and differential diagnosis of thyroid nodules. Therefore, we try to discuss the coexistence of thyroid nodules with other solid tumors. Objective: to investigate the incidence and malignancy of thyroid nodules in patients with solid tumors. To investigate the relationship between thyroid nodule and primary malignant tumor and its effect on diagnosis and treatment methods: from January 1st 2016 to March 31st 2016 all the hospitalized patients were collected as solid tumor group in the Cancer Center of the second affiliated Hospital of Anhui Medical University. TSH was measured by color Doppler ultrasonography and compared with the healthy people of the same age and gender in the same period. The incidence of thyroid nodules was statistically analyzed. Results: from January 1st 2016 to March 31st 2016, 294 patients were treated as solid tumor group (150 males and 144 females), with an average age of 57.42 卤11.27 years, ranging from 26 to 82 years, with a median age of 60 years. In the same period, 280 people (male 140, female 140, mean age 54.25 卤10.78 years, ranging from 28 to 80 years old, median age 58 years) received thyroid ultrasound and thyroid hormone examination in the physical examination center as the control group. The overall incidence of thyroid nodules and the incidence of multiple thyroid nodules in solid tumor group were higher than that in solid tumor group (P < 1 cm). The malignant rate of thyroid nodule in solid tumor group was higher than that in solid tumor group. Breast cancer was complicated with thyroid node. Thyroid nodule had no effect on clinical diagnosis and treatment of solid tumor in 104 cases, mild influence in 46 cases, moderate effect in 6 cases, and severe effect in 4 cases. Conclusion: thyroid nodule in solid tumor coexists with thyroid nodule. The rates of malignancy and malignancy were higher, The effect of thyroid nodule on the diagnosis and treatment of solid tumor is related to the condition of primary tumor. Comprehensive examination of thyroid gland may be of great help to the diagnosis and treatment of complicated disease (especially the cancer with unknown lymph node metastasis).
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R581;R730.5

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