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目的:探讨甲状腺功能亢进症(甲亢)合并甲状腺癌(甲癌)的临床病理特点。方法:回顾性分析吉林大学第一医院甲状腺外科2010年1月—2013年8月收治的甲亢合并甲癌患者临床资料,并结合文献比较。结果:手术治疗甲亢患者85例,其中31例(36.5%)合并甲癌。术前结合临床表现和颈部超声结果甲亢合并甲癌确诊率80.6%(25/31)。31例患者待甲亢症状得到控制、甲状腺功能经检查恢复正常后行手术治疗,并根据具体情况选择术式,术后均顺利出院,未发生永久性医源性喉返神经损伤及甲状旁腺功能减退。经术后病理证实,1例为髓样癌,30例为甲状腺乳头状癌;17例(54.8%)侵及被膜者,9例(29.1%)中央区淋巴结转移,各项病理特点与文献报道的单纯甲癌比较,差异均无统计学意义(均P>0.05)。结论:甲亢伴甲癌发病率有增高趋势,应强调颈部超声在该病早期诊断中的重要性,确诊后尽早行手术治疗并合理选择手术方式,预后较好。
Objective: To investigate the clinicopathological features of hyperthyroidism (hyperthyroidism) complicated with thyroid cancer (A). Methods: The clinical data of patients with hyperthyroidism and thyroid carcinoma treated by thyroid surgery from January 2010 to August 2013 in the First Hospital of Jilin University were analyzed retrospectively, and compared with the literature. Results: Surgical treatment of hyperthyroidism in 85 patients, 31 cases (36.5%) with carcinoma. Preoperative combined with clinical manifestations and ultrasound results of cervical ultrasound diagnosis of thyroid carcinoma with a rate of 80.6% (25/31). 31 cases of hyperthyroidism symptoms to be controlled, thyroid function returned to normal after surgery underwent surgery, and according to the specific circumstances of surgical procedures were selected, were discharged after surgery, no permanent ipsilateral recurrent laryngeal nerve injury and parathyroid function Decreased. Pathological findings confirmed that 1 case was medullary carcinoma, 30 cases was papillary thyroid carcinoma, 17 cases (54.8%) had invasion of the capsule and 9 cases (29.1%) had central lymph node metastasis. The pathological features and reported reports Of the simple carcinoma of the neck, the difference was not statistically significant (all P> 0.05). Conclusion: The incidence of Hyperthyroidism with Mild Carcinoma has an increasing trend. It is necessary to emphasize the importance of cervical ultrasonography in the early diagnosis of the disease. Surgical treatment should be performed as soon as possible after diagnosis and the operation method should be chosen reasonably. The prognosis is good.