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目的分析桥本甲状腺炎(HT)合并甲状腺乳头状癌(PTC)的临床及病理学特征。方法 2013年10月至2015年10月共收治PTC患者297例。其中PTC合并HT者49例为研究组,男5例,女44例,24~67岁,<45岁者27例。单纯PTC者248例为对照组,其中男60例,女188例,17~76岁,<45岁者97例。分析两组患者的临床资料,包括性别、年龄、甲状腺弥漫性肿大、血清自身免疫抗体水平、是否存在包膜侵犯、肿瘤大小、术中冰冻病理准确率、中央区淋巴结转移、TNM分期,并行统计学分析。结果与对照组比较,研究组在性别、年龄、甲状腺弥漫性肿大、血清自身免疫抗体水平、中央区淋巴结转移方面差异均有统计学意义(P均<0.05),而是否存在包膜侵犯、肿瘤大小、术中快速病理、TNM分期差异无统计学意义(P>0.05)。结论 HT合并PTC多见于女性,发病年龄较早,可伴有甲状腺弥漫性肿大及血清自身免疫抗体的升高,早期即可出现淋巴结转移。提示对HT患者应定期复查,以利其早期病变的诊疗。
Objective To analyze the clinical and pathological features of Hashimoto’s thyroiditis (HT) combined with papillary thyroid carcinoma (PTC). Methods From October 2013 to October 2015, a total of 297 PTC patients were admitted. Among them, 49 patients with PTC combined HT were study group, including 5 males and 44 females, 24 to 67 years old and 27 cases <45 years old. 248 cases of simple PTC as the control group, including 60 males and 188 females, 17 to 76 years old, <45 years old in 97 cases. The clinical data of two groups were analyzed, including gender, age, diffuse thyroid enlargement, serum autoimmune antibody level, presence of envelope invasion, tumor size, intraoperative frozen pathological accuracy, central lymph node metastasis, TNM staging, parallel Statistical analysis. Results Compared with the control group, the study group had statistically significant differences in sex, age, diffuse thyroid enlargement, serum autoimmune antibody level and central lymph node metastasis (P <0.05) There was no significant difference in tumor size, intraoperative rapid pathology and TNM staging (P> 0.05). Conclusions HT combined with PTC is more common in women. The incidence of HT is earlier, and may be associated with diffuse thyroid enlargement and elevated serum autoimmune antibodies. Early lymph node metastasis may occur. Tip HT patients should be regularly reviewed to facilitate the treatment of early lesions.