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目的探讨桥本甲状腺炎(HT)与甲状腺乳头状癌(PTC)之间的关系。方法收集2000年1月—2015年6月6 234例甲状腺结节手术患者的临床资料,术后经病理确诊为PTC 1 016例,依据合并HT与否分为合并HT及未合并HT两组,对其临床特征进行比较分析。结果 (1)6 234例患者中8.66%合并HT(540/6 234)。与未合并HT者相比,合并HT者女性多见、年龄更小、PTC检出率更高(P<0.01)。(2)1 016例PTC患者中,与未合并HT者相比,合并HT者女性更多见、平均年龄更小、高发年龄36~55岁,多发癌灶更常见、微小癌(≤1 cm)比例更高,原发灶包膜外侵犯比例、淋巴结转移率、TNM分期Ⅲ/Ⅳ期比例及BRAF突变率更低(P<0.01或P<0.05)。合并HT与PTC的发生呈正相关(P<0.01)。结论 HT与PTC的发生呈正相关。PTC合并HT患者女性更多见、预后更好。
Objective To investigate the relationship between Hashimoto’s thyroiditis (HT) and papillary thyroid carcinoma (PTC). Methods The clinical data of 6 234 patients with thyroid nodules from January 2000 to June 2015 were collected. After operation, 1 016 patients were diagnosed as PTC by pathology. According to the combination of HT or not, the patients were divided into HT group and non-HT group, The clinical features of the comparative analysis. Results (1) 8.66% of 6 234 patients had HT (540/6 234). Women with HT were more common, younger and had a higher detection rate of PTC (P <0.01) than those without HT. (2) Of the 1,016 patients with PTC, women with HT were more common and had a younger mean age, with a high incidence of 36-55 years of age, with more frequent multiple cancers, and less cancers (≤1 cm ), The proportion of primary extracapsular invasion, the rate of lymph node metastasis, the proportion of stage Ⅲ / Ⅳ in TNM stage and the mutation rate of BRAF were lower (P <0.01 or P <0.05). There was a positive correlation between HT and PTC (P <0.01). Conclusion The incidence of PTC is positively correlated with PTC. PTC patients with HT more common in women, the prognosis is better.