微小甲状腺癌合并桥本氏甲状腺炎的临床病理及颈淋巴结转移特征
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吴高松, Email: zhenjinzhou_hb@163.com

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Clinicopathologic and cervical lymph node metastatic features in patients with papillary thyroid microcarcinoma and concomitant Hashimoto’s thyroiditis
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    摘要:

    目的:探讨微小乳头状甲状腺癌(PTMC)合并桥本甲状腺炎(HT)患者的临床病理特征与颈淋巴结转移规律。 方法:回顾性分析2008年10月—2012年10月治疗的284例PTMC患者临床资料,按是否合并HT分为研究组(n=58)与对照组(n=226),分析PTMC合并HT与临床病理因素的关系,以及PTMC患者颈淋巴结转移的影响因素。 结果:58例PTMC合并HT患者中女性52例(89.7%)。单因素分析显示,性别、多发病灶、颈部侧区淋巴结转移、颈侧区合并中央区的淋巴结转移、与PTMC合并HT有关(均P<0.05);多因素分析显示,PTMC合并HT为颈侧区淋巴结转移及颈侧区合并中央区淋巴结转移的独立危险因素(均P<0.05)。 结论:PTMC合并HT以女性患者多见,常为多发病灶,并出现颈侧区淋巴结连续性转移。

    Abstract:

    Objective: To investigate the clinicopathologic features and pattern of cervical lymph node metastasis in patients with papillary thyroid microcarcinoma (PTMC) and concomitant Hashimoto’s thyroiditis (HT). Methods: The clinical data of 284 PTMC patients treated during October 2008 to October 2012 were retrospectively analyzed. The patients were divided into observational group (n=58) and control group (n=226) according to whether or not they were complicated with HT. The relations of the concomitant PTMC and HT with the clinicopathologic factors, and the affecting factors for cervical lymph node metastasis of the PTMC patients were analyzed. Results: Among the 58 patients with PTMC and HT, 52 cases (89.7%) were female. Univariate analysis showed that sex, multiple lesions, lateral cervical lymph node metastases, and lateral neck along with central compartment lymph node metastases were significantly related to the concomitant PTMC and HT (all P<0.05). Multivariate analysis showed that concomitant PTMC and HT was an independent risk factor for lateral cervical lymph node metastases and lateral neck together with central compartment lymph node metastases (all P<0.05). Conclusion: Concomitant PTMC and HT is more common in female patients, and frequently presents with multiple lesions and lateral neck serial metastases.

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郑荆洲,童传明,吴高松.微小甲状腺癌合并桥本氏甲状腺炎的临床病理及颈淋巴结转移特征[J].中国普通外科杂志,2014,23(11):1557-1560.
DOI:10.7659/j. issn.1005-6947.2014.11.020

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  • 收稿日期:2014-01-22
  • 最后修改日期:2014-05-09
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  • 在线发布日期: 2014-11-15