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目的探讨结节性甲状腺肿合并甲状腺癌的临床特点和诊治措施,为临床治疗提供理论依据。方法收集并分析286例结节性甲状腺肿合并甲状腺癌患者的临床资料。结果 CT和超声检查的结果显示,结节性甲状腺肿合并单发甲状腺癌患者30例(10.5%),合并多发病灶的患者256例(89.5%),双侧病灶的患者135例(47.2%)。与结节性甲状腺肿组织特征相比,甲状腺癌结节边缘中断征(32%)、边缘不清(70%)和细颗粒状钙化(84%)的比例显著增高,差异均有统计学意义(均P<0.05)。乳头状癌202例,滤泡状癌50例,未分化癌32例,髓样癌2例,患者均无远隔器官的转移,其中N0期202例,N1期84例,T1期196例,T2期40例,T3期30例,T4期20例。所有患者均接受手术治疗,无严重并发症和死亡。结论在临床治疗中要高度警惕单侧孤立结节或存在钙化的甲状腺结节,应结合病理检查给予积极的手术治疗,以免结节恶化。
Objective To investigate the clinical features, diagnosis and treatment of nodular goiter complicated with thyroid cancer and provide a theoretical basis for clinical treatment. Methods The clinical data of 286 patients with nodular goiter complicated with thyroid cancer were collected and analyzed. Results CT and ultrasonography showed that in 30 patients (10.5%) with nodular goiter and solitary thyroid cancer, 256 patients (89.5%) had multiple lesions and 135 patients (47.2%) had bilateral lesions. . Compared with the characteristics of nodular goiters, the proportion of marginal edge nodules in thyroid cancer (32%), marginal margin (70%) and fine granular calcification (84%) were significantly higher than those in nodular goiter (All P <0.05). There were 202 cases of papillary carcinoma, 50 cases of follicular carcinoma, 32 cases of undifferentiated carcinoma and 2 cases of medullary carcinoma. There were 202 cases in N0 stage, 84 cases in N1 stage, 196 cases in T1 stage, 40 cases of T2, 30 cases of T3, 20 cases of T4. All patients underwent surgical treatment without serious complications and death. Conclusion In clinical treatment should be highly vigilant unilateral nodules or presence of calcified thyroid nodules should be combined with pathological examination to give a positive surgical treatment to prevent nodular deterioration.