桥本甲状腺炎合并甲状腺癌的临床表现及病理分析

发布时间：2018-08-26 08:03

【摘要】：目的研究桥本甲状腺炎(HT)合并甲状腺癌(PTC)的临床表现,并进行病理分析。方法选取温州医科大学附属第三医院收治的HT合并PTC患者30例为观察组,另外选择同期收治的单纯HT患者70例为对照组,采用酪氨酸激酶受体(RET)免疫组化法进行染色,对两组临床表现及病理进行分析。结果两组患者的临床表现有一定的相似性,包括胸闷、气短、声嘶、颈部压迫感和不适感。其中观察组患者颈部压迫感14例,颈部不适感7例,胸闷及气短4例,声嘶3例,甲状腺功能减退症2例。对照组患者颈部压迫感31例,颈部不适感18例,胸闷及气短12例,声嘶6例,甲状腺功能减退症3例。HT合并PTC患者病理的组织形态分布最常见的为淋巴细胞浸润、癌细胞胞质嗜酸性、纤维化。对照组患者病理组织形态多表现为多样化特点,大部分为结节状。观察组主要为乳头状癌,且观察组RET阳性率高于对照组,差异有统计学意义(P0.01)。结论 HT与PTC的临床症状和病理基础具有一定的相似性,其中HT是引发患者发生PTC的重要病因,对HT患者积极的治疗,可有效防止疾病的恶化,临床应当予以重视。
[Abstract]:Objective to study the clinical manifestations of Hashimoto's thyroiditis (HT) complicated with thyroid carcinoma (PTC) and to make pathological analysis. Methods Thirty patients with HT combined with PTC were selected as observation group and 70 patients with simple HT as control group. Tyrosine kinase receptor (RET) immunocytochemistry method was used to detect tyrosine kinase receptor (RET). The clinical manifestations and pathology of the two groups were analyzed. Results the clinical manifestations of the two groups were similar, including chest tightness, shortness of breath, hoarseness, neck pressure and discomfort. In the observation group, there were 14 cases of cervical compulsion, 7 cases of neck discomfort, 4 cases of chest tightness and shortness of breath, 3 cases of hoarseness and 2 cases of hypothyroidism. In the control group, there were 31 cases of cervical compulsion, 18 cases of neck discomfort, 12 cases of chest tightness and shortness of breath, 6 cases of hoarseness, 3 cases of hypothyroidism and 3 cases of hypothyroidism. The most common histopathologic distribution of HT with PTC was lymphocytic infiltration. Cancer cell cytoplasm eosinophilic, fibrosis. In the control group, the histopathologic features were diversified, most of which were nodular. The positive rate of RET in the observation group was higher than that in the control group (P0.01). Conclusion the clinical symptoms and pathological basis of HT and PTC are similar, and HT is an important cause of PTC in patients. Active treatment of HT patients can effectively prevent the deterioration of the disease, and should be paid attention to clinically.
【作者单位】：温州医科大学附属第三医院内分泌科;
【分类号】：R581.4;R736.1

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