摘要
目的 研究妊娠对分化型甲状腺癌的影响.方法 回顾性对照分析我院头颈外科收治的妊娠相关甲状腺癌125例（包括分娩前9个月内、分娩后1年内确诊的甲状腺癌）为妊娠相关组和同年龄段非妊娠期女性患者691例（非妊娠组）的临床资料.结果 甲状腺癌术后颈部复发转移,妊娠相关组28例（22.4%）,非妊娠组90例（13%）,妊娠相关组甲状腺癌术后颈部复发转移高于非妊娠组（P＜0.05）.妊娠相关组肿瘤最大直径平均为2.6 cm,非妊娠组2.1 cm.妊娠相关组多灶性癌19例（19.6%）,非妊娠组58例（9.6%）（P＜0.05）.妊娠相关组甲状腺包膜外侵犯23例（23.7%）,非妊娠组65例（10.8%）（P＜0.05）.妊娠相关组中央区和侧颈部淋巴结转移分别为67例（53.6%）和35例（28%）,非妊娠组分别为296例（42.8%）和117例（16.9%）（P＜0.05）.妊娠相关组淋巴结外侵19例（15.2%）,非妊娠组32（4.6%）（P＜0.05）.结论 妊娠使分化型甲状腺癌更易出现包膜外侵犯、多灶性癌、颈部淋巴结转移和淋巴结外侵,可能促使甲状腺癌恶化.对于甲状腺癌术后的患者,妊娠可能增加其颈部复发转移的风险.但妊娠不影响甲状腺癌的病理分期,预后良好.
Objective To study the impact of pregnancy on differentiated thyroid cancer. Methods Retrospective comparative analysis were made between pregnancy-related thyroid cancer patients （ including nine months before delivery and one year after delivery） and the age-matched non-pregnancy-related thyroid cancer patients treated in the Department of head and neck, Fudan University Shanghai Cancer Center. Results There were 125 cases of pregnancy-related thyroid cancer patients from 1998 to 2008, including 28 cases （22.4%） of neck recurrence and metastasis after the surgery of thyroid cancer, meanwhile there were 691 cases of the agematched non-pregnancy thyroid cancer patients, including 90 cases （ 13% ） of neck recurrence and metastasis after the surgery of thyroid cancer. The rate of neck recurrence and metastasis after the surgery of thyroid cancer in the pregnancy-related group was higher than that in the non-pregnancy related group （ P 〈 0.05）. The maximum diameter of tumor in the pregnancy-related group and the non-pregnancy group is 2. 1 cm and 2.6cm respectively.There were 19 cases of multi-focal cancer （ 19.6% ） in the pregnancy-related group and 58 cases （9. 6% ） in the non-pregnant group, P 〈0.05. There were 23 patients （23.7%） of extrathyroid invasion in the pregnancy-related group and 65 patients （ 10.8% ） in the non-pregnant group, P 〈0.05. There were 67 cases （53.6%） and 35 cases （28%） of the central and lateral cervical lymph node metastasis in the pregnancy-related group respectively and 296 cases （42.8%） and 117 cases （16. 9% ）in the non-pregnant group, P 〈0.05. There were 19 cases （15.2%） of extralymph invasion in the pregnancy-related group and 32 cases （4.6%） in the non-pregnant group, P 〈 0.05. Conclusions The incidence of Extrathyroid invasion, multi-focal cancer, cervieal lymph node metastasis and extralymph invasion of the differentiated thyroid cancer is higher in pregnancy-related patients.Pregnancy may deteriorate the prognosis of thyroid cancer. For patients after the surgery of thyroid cancer, pregnancy may increase the risk of neck recurrence and metastasis. However, pregnancy does not affect the stage of thyroid cancer and the prognosis is still good.
出处
《中华内分泌外科杂志》
CAS
2010年第4期252-254,共3页
Chinese Journal of Endocrine Surgery
关键词
甲状腺癌
妊娠
Thyroid cancer
Pregnancy
