【摘要】 目的研究乳头状甲状腺癌并存结节性甲状腺肿的临床病理特征。方法回顾性分析2014年10月—2019年12月本院收治的首次行原发病灶切除、颈部淋巴结清扫术且病理和检验资料完整的乳头状甲状腺癌患者428例为甲状腺癌组(其中单纯组226例,并存结节性甲状腺肿组202例)以及同期检查血清促甲状腺激素及甲状腺自身抗体水平的208例结节性甲状腺肿患者(结节性甲状腺肿组)的临床资料。比较分析单纯组和并存组的年龄、性别、民族、病灶大小、病灶个数、单双侧发病、被膜侵犯、颈部淋巴结转移、临床分期的差异;比较三组促甲状腺激素及甲状腺自身抗体水平的差异。结果并存组病灶大于1 cm者为48.5%,单纯组病灶在0.5～1 cm者52.2%,差异具有统计学意义(P<0.01);并存组单发病灶和单侧病灶发生率分别为86.6%和94.1%,单纯组分别为48.7%和51.3%,差异具有统计学意义(P<0.01);并存组颈部淋巴结转移率为57.9%,单纯组46.9%,差异具有统计学意义(P<0.05)。TSH、TPOAb和Anti-Tg在甲状腺癌组均高于结节性甲状腺肿组,差异具有统计学意义(P<0.01); Tg在结节性甲状腺肿组高于甲状腺癌组,差异具有统计学意义(P<0.01)。结论乳头状甲状腺癌并存结节性甲状腺肿组病灶偏大,单侧病灶多,单发病灶多,颈部淋巴结转移率高。更多还原

【Abstract】 Objective To explore the clinicopathological features of papillary thyroidea carcinoma coexistent nodular goiter.Methods The clinical data of 428 cases of patients diagnosed with papillary thyroidcarcinoma and 208 cases of patients with nodular goiter were retrospectively analyzed.The patients with papillary thyroid carcinoma received first time total resection of the primary cancer and neck nodal dissection from October2014 to December 2019( Among them,226 patients with single papillary thyroid carcinoma were in the single group,202 patients with coexistent nodular goiter were in the combined nodular goiter group). The 208 patients with nodular goiter those accepted the tests of TSH and the level of thyroid auto-antibodies in the period mentioned above were in the nodular goiter group.All their inspection data are complete.The difference of age,sex,nationality,lesion size and number,onset of unilateral or bilateral,capsule invasion,neck lymph node metastasis and clinical stages between single group and combined group were compared.The differences of TSH level and the level of thyroid auto-antibodies among the three groups were compared. Results 48. 5% patients have their lesions larger than 1 cm in diameter in the combined group while 52.2% patients have the lesion size between 0.5-1 cm in the single group,the difference was statistically significant( P< 0.01). The onset rates of single nodular and unilateral lesion were 86.6% and 94.1% in the combined group,and 48.7% and 51.3% in the single group individually,the differences were statistically significant( P<0.01).The rate of neck lymph node metastasis was 57.9% in the combined group and 46.9% in the single group,the difference was statistically significant( P< 0.05).Levels of TSH,TPOAb and Anti-Tg in the patients with papillary thyroid carcinoma were all higher than those in the nodular goiter group( P < 0. 01). Tg in the nodular goiter group was higher than that in the papillary thyroid carcinoma,P< 0. 01. Conclusions The patients who are in the group of papillary carcinoma coexistent nodular goiter have larger lesions,more single lesions,more unilateral lesions and higher rate of neck lymph node metastasis.更多还原