摘要
目的 探讨桥本病合并甲状腺恶性肿瘤的临床发病关系及其诊断、治疗和预后。方法 回顾 1984～2 0 0 1年 138例桥本病合并甲状腺恶性肿瘤 19例 ,结合文献进行临床分析。结果 发病率为 13 77% ( 19/ 138)。其中桥本病合并甲状腺癌 17例 ,发病率为 12 32 % ,合并淋巴瘤 2例 ,发病率为 1 45 %。全组病人均出现甲状腺结节 ,经手术治疗后并随访淋巴瘤死亡 1例 ,甲状腺癌 17例随访无死亡及复发 ,预后好。结论 对于合并甲状腺结节的桥本病应考虑手术治疗。桥本病合并甲状腺恶性肿瘤临床诊断较困难。术前常规测血TGA、MCA、甲状腺核素显影、细针穿刺、术中快速冰冻切片 ,有利于术前、术中确诊及正确的手术方式选择。
Objective To study the clinical relationship between Hashimoto disease and thyroid malignant tumors and its diagnosis,treatment and prognosis. Methods A restrospective review of the data of 19 patients with Hashimoto disease complicated witth thyroid malignant tumors who were treated from Jan 1984 to Jun 2001 was carried out in this study. Their data together with the literature concerned were analysed.Results The morbidity was 13.77%(19/138). Among which 17 were thyroid cancer with a concurrent rate of 12.32%, 2 with thyroid malignant lymphoma (1.45%).All patients had thyroid nodules and received thyroidectomy.All postoperative patients were followed up for an average period of 6.5 years ,and a lymphoma patients died.Seventeen patients with thyroid cancer were alive without recurrence and had a good prognosis.Conclusion Hashimoto disease complicated with thyroid nodules should be treated surgically. The clinical diagnosis of coexistence of Hashimoto disease and thyroid malignant tumors is still difficult. The key to diagnosis and rational treatment includes detailed understanding its clinical feature,routine examination of serum antibodies and scintigraphic thyroid scan or FNAB and quick frozen pathologic section in operation.
出处
《中国实用外科杂志》
CSCD
北大核心
2003年第3期156-157,共2页
Chinese Journal of Practical Surgery
