摘要
目的 分析桥本甲状腺炎与甲状腺乳头状癌之间的关系.方法 回顾性分析2001年至2011年于本院进行甲状腺切除手术的5 440例甲状腺结节患者,术后病理确诊甲状腺乳头状癌1 709例,对伴发与未伴发桥本甲状腺炎的甲状腺结节患者及甲状腺乳头状癌患者的年龄、性别、结节大小、淋巴结转移、侵袭状态等临床病理特征进行比较,并对甲状腺乳头状癌的独立危险因素进行多因素logistic回归分析.结果 (1)5440例甲状腺结节患者中,6.5％ (354/5 440)患者伴发桥本甲状腺炎,与未伴发桥本甲状腺炎的患者相比,伴发桥本甲状腺炎的患者女性比例更高(88.1％对68.3％,P＜0.01)、患者更年轻[(45.40±12.09对47.47±12.42)岁,P＜0.01]、结节直径更小[(1.93±1.46对2.62±1.70)cm,P＜0.01]、甲状腺乳头状癌发生的比例显著升高(52.26％对30.29％,P＜0.01).(2)1 709例甲状腺乳头状癌中,与未伴发桥本甲状腺炎组相比,伴发桥本甲状腺炎的患者女性比例更高(86.49％对67.98％,P＜0.01)、患者更年轻[(41.77±11.86对44.08±11.93)岁,P＜0.05]、结节直径更小[(1.34±1.19对1.58±1.26)cm,P＜0.05]、TNM分期为Ⅲ/Ⅳ期的比例低(7.0％对16.8％,P＜0.01)、甲状腺外侵袭的发生率低(2.2％对7.9％,P＜0.01).(3)多因素回归分析显示桥本甲状腺炎是甲状腺乳头状癌的独立危险因素[0R=2.413,95％CI1.879 ～3.098,P＜0.05].结论 伴甲状腺结节的桥本甲状腺炎患者患甲状腺乳头状癌的风险显著增加.与未伴发桥本甲状腺炎组相比,伴发桥本甲状腺炎的甲状腺乳头状癌患者女性更常见、发病年龄更年轻、结节直径更小,但是预后可能会更好.
Objective To evaluate the clinical relationship between Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC).Methods A total of 5 440 patients underwent thyroidectomy in the Department of Endocrinology of Chinese PLA General Hospital from 2001 to 2011.Of these patients,1 709 patients with histologically confirmed PTC were analysed according to the presence or absence of concurrent HT.Several clinicopathological factors,such as age,gender,nodular size,invasive status,lymph node metastasis were compared between the two groups.Results (1) Of 5 440 patients with thyroid nodules,6.5％ (354/5 440) patients had concurrent HT.Compared with those without HT,a greater female preponderance (88.1％ vs 68.3％,P＜0.01),younger age [(45.40 ± 12.09 vs 47.47 ± 12.42) years,P＜0.01],smaller tumour size [(1.93 ± 1.46 vs 2.62 ±1.70)cm,P＜0.01],and higher prevalence of PTC were found in patients with HT (52.26％ vs 30.29％,P＜0.01).(2) Of 1 709 patients with PTC,10.8％ (185/1 709) patients had concurrent HT.Younger age at presentation[(41.77 ± 11.86 vs 44.08 ± 11.93) years,P＜0.05],a greater female preponderance (86.49％ vs 67.98％,P＜0.01),smaller tumour size [(1.34 ± 1.19 vs 1.58 ± 1.26) cm,P＜0.05],lower incidence of delayed treatment (7.0％ vs 16.8％,P＜0.01),and lower incidence of extrathyroidal extension (2.2％ vs 7.9％,P＜0.01)were noted in patients with HT compared with those without HT.(3) A multivariate analysis indicated that the presence of HT was a risk factor for PTC [OR =2.413,95％ CI 1.879-3.098,P ＜ 0.05].Conclusion Histologically confirmed HT is associated with a significantly higher risk of PTC,but the coexistence of HT in PTC cases may be associated with a better prognosis compared with those of PTC without HT.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2014年第4期-,共5页
Chinese Journal of Endocrinology and Metabolism
基金
全军医学科技“十二五”科研项目
