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目地探讨原发性甲状腺功能亢进症(原发性甲亢)合并甲状腺癌(甲癌)的诊治方法。方法回顾性分析我院2009年7月～2013年2月经手术及病理证实的9例原发性甲亢合并甲癌临床资料,分析其诊断及治疗。结果在本组9例原发甲亢合并甲状腺癌的病例中,术前细针穿刺细胞学检查确诊2例,术前误诊、漏诊率高达77.8%(7/9)。术中快速病理明确诊断88.9%(8/9)。1例术后病理检查明确诊断。9例患者均行手术治疗,行患侧甲状腺全切除术+对侧甲状腺次切除术6例,甲状腺全切除术3例(其中1例为二次手术)。术后均服用左旋甲状腺素片进行内分泌治疗。所有患者均获随访,无一例复发、转移或死亡。结论原发甲亢合并甲状腺癌近年患者有所增多;术前诊断比较困难,术前应综合运用B超、细针穿刺细胞学等检查,本病的确诊有赖于病理学诊断,术前、术中明确诊断,避免患者行第二次手术。采取合理的手术方式,术后再根据甲功结果服用左旋甲状腺素片,患者术后疗效较好。
Objective To investigate the diagnosis and treatment of primary hyperthyroidism (primary hyperthyroidism) with thyroid cancer (A). Methods The clinical data of 9 patients with primary hyperthyroidism complicated with carcinoma confirmed by operation and pathology from July 2009 to February 2013 in our hospital were analyzed retrospectively. The diagnosis and treatment were analyzed. Results In the group of 9 cases of primary hyperthyroidism complicated with thyroid cancer, 2 cases were confirmed by fine needle aspiration cytology before operation. Misdiagnosis before operation was as high as 77.8% (7/9). Rapid intraoperative pathological diagnosis of a clear 88.9% (8/9). A case of postoperative pathological examination a clear diagnosis. Nine patients underwent surgical treatment. Six cases underwent total thyroidectomy + contralateral thyroidectomy and three cases underwent total thyroidectomy (including one case underwent second surgery). After taking levothyroxine tablets for endocrine therapy. All patients were followed up without recurrence, metastasis or death. Conclusions Primary Hyperthyroidism with Thyroid Cancer in recent years, an increase in patients; preoperative diagnosis is more difficult, preoperative comprehensive diagnosis using B-aspiration, fine needle aspiration cytology and other tests, the diagnosis of this disease depends on pathological diagnosis, preoperative and postoperative A clear diagnosis, to avoid the patient underwent a second surgery. Take a reasonable operation, postoperative thyroid function according to the results of taking levothyroxine tablets, patients with better efficacy.