【作者】 徐敏；

【导师】 田兴松；

【作者基本信息】 山东大学 ， 外科学（专业学位）， 2014， 硕士

【摘要】 研究目的：研究乳腺癌患者再发甲状腺癌的潜在关系与分子分型特征。乳腺癌是女性最常见的恶性肿瘤之一。部分大城市报道乳腺癌占女性恶性肿瘤的首位。而近年来,随着人们医疗卫生知识的扩展普及,对甲状腺疾病的认识也与日提高,甲状腺疾病的发病率逐年升高。临床研究发现乳腺癌患者有相当多病人合并患有甲状腺癌,目前对于乳腺癌与甲状腺癌之间的发展关系尚无定论。多项研究表明甲状腺癌的发生与雌激素受体有关。研究方法：本研究选取2012年和2013年共116例经病理证实为乳腺癌的女性患者,统计其甲状腺疾病的发病情况并对其进行分子分型,其中LuminalA型15例,均无甲状腺癌,合并结节性甲状腺肿4例；LuminalB型57例,合并甲状腺癌10例,结节性甲状腺肿34例；Her-2过表达型27例,其中合并甲状腺癌5例,结节性甲状腺肿10例,“三阴性”乳癌17例,合并甲状腺癌8例,结节性甲状腺肿6例。116例病例中共有合并甲癌患者23例,均经手术治疗,病理证实均为甲状腺乳头状癌。对四种分子分型进行Fisher检验,检测其分子分型相互之间是否有统计学差异。研究结果：1、在乳腺癌患者中,甲状腺乳头状癌患病率明显高于人群中的患病率。经Fisher确切概率法检验,Pr<=P0.0039,结果说明各分子分型之间对于患甲状腺疾病有明显差异。浸润性乳腺癌患者更易患甲状腺疾病(本研究中包括结节性甲状腺肿和甲状腺乳头状癌)。所收集的数据有统计学意义。2、两两组之间的Fisher检验,证明除“三阴性”乳腺癌之外,其他分子类型之间甲状腺疾病的发生并无明显差异。3、非“三阴性”乳腺癌与“三阴性”乳腺癌进行四格表的x2检验、Fisher确切概率检验得Pr=0.0055, Pr<0.0071,说明“三阴性”乳腺癌与非“三阴性”乳腺癌在甲状腺癌的发病上有差异。研究结论：1、乳腺癌患者罹患甲状腺疾病的概率明显高于普通人群的发病率。2、乳腺癌的各分子分型对于甲状腺疾病的发生有明显的差异性。“三阴性”乳腺癌患者检查出甲状腺疾病的例数明显多于其他分子分型,与其他类型相比更易发生甲状腺癌。更多还原

【Abstract】 Background Researching potential relationship of breast cancer patients with recurrent thyroid cancer and the differences in subtype. Breast cancer is one of the most common malignant tumor of female diseases. Many reports of the big city about breast cancer show it as the first female malignancy. In recent years, with a raising of standards in medical treatment and improve consciouses of thyroid disease, the prevalence rate increased year by year. Clinical study found that breast cancer patients have considerable recurrent thyroid cancer patients. There is no consentaneous way to the relationship of breast cancer and thyroid cancer. A number of studies have shown that the incidence of thyroid cancer associated with estrogen receptor.Methods This study selected116women patients with pathologically confirmed invasive breast cancer during year2012and2013. According to the molecular classification of breast cancer,the116patients were divided into four types.Type LuminalA including15cases with no thyroid carcinoma and6cases of nodular goiter. Type LuminalB including57cases with10cases of thyroid carcinoma,34cases of nodular goiter. Type Her-2expression including27cases with5cases of thyroid carcinoma and10cases of nodular goiter,12cases without thyroid disease. Type "three negative"(also called basal like)breast cancer(TBNC) including17cases with8cases of thyroid carcinoma and6cases of nodular goiter. In116cases there were23cases of thyroid cancer patients that were all treated by operation. Pathologically confirmed that they were all papillary thyroid carcinoma. Chi square test was performed on four kinds of molecular subtypes to detect the interaction between them and whether there is significant difference.Result:1、In patients with breast cancer, thyroid carcinoma was significantly higher than the prevalence of morbidity in the general population(Pr<P=0.0039).Invasive breast cancer patients were more likely to have thyroid disease.2、The Fisher test between two two groups, besides "three negative" breast cancer incidence, there was no significant difference between other molecular types of thyroid diseases.3、Non-"three negative" breast cancer and the "three negative" breast cancer were four tables by X2test, Fisher exact probability test was Pr=0.0055, Pr<0.0071, non basal like and basal like breast cancer have differences in the incidence of thyroid cancer.Conclusion1、Patients found initially to have breast may be predisposed to develop the thyroid carcinoma.2、Trough Fisher test,Pr<P=0.0039.The results show that the risk of invasive breast cancer patients with thyroid disease (in the study include nodular goiter and thyroid papillary carcinoma) were higher.更多还原