桥本氏甲状腺炎合并甲状腺乳头状癌的临床特点及分析

发布时间：2018-04-03 04:06

  本文选题：桥本氏甲状腺炎　切入点：甲状腺乳头状癌　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:桥本氏甲状腺炎合并甲状腺乳头状癌的现象越来越多的被人们发现,为了探究桥本氏甲状腺炎合并甲状腺乳头状癌的临床特点,将其与单纯甲状腺乳头状癌进行比较和分析,从而加深对该疾病的认知,并为更好的诊断、治疗及预后评估提供依据。方法:回顾性分析山西医科大学附属山西省肿瘤医院2015年11月到2016年11月经头颈外科手术治疗且病理证实为桥本氏甲状腺炎合并甲状腺乳头状癌57例,分为A组,单纯甲状腺乳头状癌116例,分为B组。对比两组病例在性别、年龄、肿瘤大小、术前TSH水平、微小癌发生率、中央组淋巴结转移率、TNM分期方面的特点。结果:1、A组中女性患者50例,占该组87.7%,B组中的女性患者为76例,占该组65.5%,P0.000,差异有统计学意义。2、A组患者年龄为42.3±13.6岁,B组患者年龄为45.7±14.5岁,P=0.142,差异无统计学意义。3、A组患者肿瘤大小为1.46±0.87cm,B组患者肿瘤大小为2.02±1.21cm,P0.000,差异有统计学意义。4、A组患者术前TSH水平为2.34±2.12m IU/L,B组患者为1.73±1.56 m IU/L,P=0.028,差异有统计学意义。5、A组患者微小癌发生率为42.1%,B组为37.1%,P=0.523,差异无统计学意义。6、A组患者中央组淋巴结转移率为24.6%,B组患者淋巴结转移率为45.7%,P=0.007,差异有统计学意义。7、TNM分期情况为:A组Ⅰ期患者43人,占该组的75.4%,Ⅱ期患者3人,占该组的5.3%,Ⅲ期患者6人,占该组的10.5%,Ⅳ期患者5人,占该组8.8%;B组Ⅰ期患者35人,占该组的30.2%,Ⅱ期患者24人,占该组20.7%,Ⅲ期患者39人,占该组的33.6%,Ⅳ期患者18人,占该组的15.5%。A组Ⅰ/Ⅱ期患者46人,占该组80.7%;B组Ⅰ/Ⅱ期患者59人,占该组50.9%,P0.000,差异有统计学意义。结论:桥本氏甲状腺炎合并甲状腺乳头状癌更好发于女性患者,术前TSH水平明显高于单纯PTC患者,该指标可能协助区分两种疾病,并且具有肿瘤直径更小、中央组淋巴结转移率更低、临床分期更早的特点,提示HT可能起到限制PTC原发灶生长及淋巴结转移的作用。
[Abstract]:Objective: to investigate the clinical features of Hashimoto's thyroiditis complicated with papillary thyroid carcinoma, more and more cases of Hashimoto's thyroiditis complicated with thyroid papillary carcinoma have been found in order to explore the clinical characteristics of Hashimoto's thyroiditis with thyroid papillary carcinoma.It is compared with simple papillary thyroid carcinoma in order to deepen the understanding of the disease and provide evidence for better diagnosis, treatment and prognosis evaluation.Methods: a total of 57 patients with Hashimoto's thyroiditis complicated with thyroid papillary carcinoma from November 2015 to November 2016 in Shanxi Cancer Hospital affiliated to Shanxi Medical University were analyzed retrospectively.116 cases of papillary thyroid carcinoma were divided into group B.The characteristics of sex, age, tumor size, preoperative TSH level, the incidence of microcarcinoma and the lymph node metastasis rate in central group were compared between the two groups.Results there were 50 female patients in group A and 76 cases in group B.鍗犺�ョ唬�

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