结节性甲状腺肿与甲状腺癌的关系以及甲状腺切除术后复发的原因

目的 探讨结节性甲状腺肿与甲状腺癌的关系以及甲状腺切除术后复发的原因.方法 选择甲状腺结节患者,一共260例,回顾性分析患者术后复发有关的因素.结果 良性结节性甲状腺肿235例,伴有乳头状增生35例,占14.89％;伴有非典型增生30例,占12.77％,伴有癌变均为微小癌5例,占2.13％.甲状腺癌25例,其中乳头状癌15例,占甲状腺癌60％;滤泡癌5例,占20％;髓样癌1例,占4％,未分化癌4例,占16％.甲状腺癌周围组织伴有结节性甲状腺肿病变为20例,占甲状腺癌的80％.随访期间复发病例一共20例,占7.69％.肿瘤大小、手术方式、病理类型、是否行淋巴结清扫与术后复发具有显著相关性.影响手术预后情况的独立因素包括肿瘤最大直径>4 cm、手术方式为单侧腺叶加峡部切除、病理类型为未分化癌、未作淋巴结清扫.结论 结节性甲状腺肿是甲状腺癌的癌前病变,甲状腺切除术后患者复发的危险因素广泛而复杂.

The Relationship between Nodular Goiter and Thyroid Cancer and the Causes of Recurrence after Thyroidectomy

Objective To investigate the relationship between nodular goiter and thyroid cancer and the causes of recurrence after thyroidectomy.Methods 260 cases of thyroid nodule patients were selected,the postoperative recurrence related factors were retrospectively analyzed.Results Benign nodular goiter in 235 cases,35 cases with papillary hyperplasia,accounted for 14.89％;30 cases with atypical hyperplasia,accounted for 12.77％,with cancer were small carcinoma in 5 cases,accounted for 25 cases of 2.13％.thyroid carcinoma,including 15 cases of papillary carcinoma of thyroid carcinoma,accounted for 60％Follicular carcinoma;5 cases,accounted for 20％;1 cases of medullary carcinoma,accounted for 4％,4 cases of undifferentiated carcinoma,accounted for 16％.of thyroid cancer surrounding tissue with nodular goiter lesions in 20 cases,accounted for 80％.recurrence during follow-up of thyroid cancer,a total of 20 cases,accounted for 7.69％.Tumor size,surgical method,pathological type,lymph node dissection and postoperative recurrence had significant correlation.The independent factors affecting the prognosis of surgery including tumor maximum diameter of >4 cm,the operation mode for unilateral lobe with isthmus resection,pathological type of undifferentiated carcinoma,without lymph node dissection.Conclusion Thyroid nodules goiter is a precancerous lesion of thyroid cancer,risk factors of relapse after thyroidectomy is extensive and complex.