47例食管癌伴发甲状腺病变的临床病理分析

目的了解食管癌伴发甲状腺病变的临床病理特点。方法从活检库中筛选同时进行食管癌根治术和甲状腺结节切除术的病例,并观察食管癌伴发甲状腺病变的情况。结果 5 158例食管癌根治术患者中,同时切除部分甲状腺病变者47例,病理结果示,结节性甲状腺肿29例,甲状腺腺瘤5例,桥本氏甲状腺炎2例,正常甲状腺组织7例,甲状腺乳头状癌2例,甲状腺鳞癌2例。2例甲状腺鳞癌均为食管胸上段鳞癌伴发,并且分别伴有结节性甲状腺肿和桥本氏甲状腺炎。2例甲状腺乳头状癌均为食管胸中段癌伴发。不同部位食管癌合并甲状腺病变的概率由上至下逐渐减小,差异有统计学意义(P<0.05)。胸上段食管癌伴发甲状腺鳞癌概率高于胸中段和胸下段食管癌(P<0.05)。结论食管癌发生甲状腺转移罕见,甲状腺慢性疾病的基础可能是导致转移性鳞癌的一个重要因素。

The Clinical and Pathological Analyses of 47 Cases of Thyroid Gland Nodule Associated with Esophageal Cancer

Objective To understand the clinical and pathological features of thyroid gland disease associated with esophageal cancer.Methods The patients with esophageal cancer and thyroid gland nodule resection were bolted from biopsy database,and the incidence of thyroid gland disease was observed.Results Of the 5 158 patients with esophageal cancer,the radical corrections of esophageal cancer and thyroid gland nodule were operated in the 47 patients(29 cases of nodular goiter,5 cases of thyroid adenoma,2 cases of Hashimoto’s thyroiditis,7 cases of normal thyroid organization,2 cases of thyroid gland papillary cancer,2 cases of thyroid gland squamous cell cancer).The 2 cases of thyroid gland squamous cell cancer were from superior segment esophageal cancer and were concurrent with nodular goiter or Hashimoto’s thyroiditis.In different positions of esophageal cancer,the chances of comorbid thyroid lesions were coincidently reduced from top to bottom,there was significant difference(P<0.05).The incidence of thyroid gland squamous cell cancer associated with superior segment esophageal cancer was higher than those of middle and lower esophageal cancer(P<0.05).Conclusion Thyroid metastatic cancer from esopha-geal cancer was uncommon,thyroid chronic disease may be an important factor of thyroid metastatic cancer.