异位甲状腺与甲状腺肿瘤

目的：探讨异位甲状腺及其肿瘤的临床病理学特点及诊治原则。方法：对３２例舌根甲状腺及６例其它中线部位的异位甲状腺之临床病理学资料进行了分析。对５９例因“侧方异位甲状腺”而行同侧或双侧甲状腺切除的后病理亦作了分析。结果：３２例舌根甲状腺无症状者１１例,有症状性者２１例,完全性异位１６例,部分尾异位１６例,１６例给予甲状腺素１例无效,８例行手术切除术后病理显示２例腺瘤性甲状腺肿、２例甲状腺腺瘤、例甲状腺     

甲状腺手术后发生甲状腺肿瘤的原因探讨

甲状腺手术后发生甲状腺肿瘤的原因探讨王怡淳，张筱骅，庄建华温州市第二人民医院（３２５０００）甲状腺手术是否会促使残余腺体发生甲状腺肿瘤，这是医生感兴趣的问题，本文就此问题结合我们的资料做一简要分析。临床资料从１９８６－１９９３年，我们三所医院共碰到甲...     

甲状腺转录因子在甲状腺良恶性病变中的表达

目的：探讨甲状腺转录因子（TTF－1）在甲状腺常见良恶性病变中的表达情况，并与甲状腺球蛋白（TG）和降钙素（CT）进行比较。方法：采用Envision二步免疫组织化学分析法分别检测TTF－1和TG在45例常见的甲状腺良性病变和65例甲状腺癌中的表达，其中10例甲状腺髓样癌加做CT检查。结果：TTF－1为核阳性，TG和CT为胞浆阳性。甲状腺滤泡细胞起源的良性病变TTF－1和TG阳性率均为100.0%(45/45)；而相应的恶性肿瘤TTF－1和TG的阳性率分别为89.1%(49/55)和85．5％（47／55）。起源于甲状腺滤泡旁C细胞的髓样癌TTF－1阳性率为70.0%(7/10)，CT和TG阳性率分别为100.0%(10/10)和0（0／10）。结论：TTF－1在甲状腺常见良恶性病变中阳性率高，因其特异地表达在细胞核，是一种很好的甲状腺滤泡细胞和滤泡旁C细胞特异性标记物。     

甲状腺残体的特征及其在甲状腺切除手术中的临床意义

目的 探索甲状腺残体的出现频率、大小、形态、与甲状腺的位置关系等特征,以提高对甲状腺残体的认识,促进甲状腺组织的完整切除。方法 选择2021年11月至2022年10月于南京医科大学第一附属医院甲状腺外科行甲状腺切除手术患者879例。术前甲状腺超声或细针穿刺细胞学检查提示单侧甲状腺肿瘤,切除病灶侧腺叶;若提示双侧甲状腺肿瘤,行甲状腺全部切除,切除甲状腺组织行快速冰冻切片病理检查。术中对甲状腺残体进行探查、解剖,根据甲状腺残体与甲状腺的位置关系,将甲状腺残体分为Ⅰ型(甲状腺下极向下突出的残体组织与甲状腺相延续)、Ⅱ型(甲状腺残体紧邻甲状腺下极,无任何组织相连)、Ⅲ型(甲状腺残体通过细窄的纤维束带与甲状腺相连)、Ⅳ型(甲状腺下方独立的甲状腺组织,与甲状腺无任何连接),记录各型残体直径、发生率。结果 入组患者中252例(28.7%)接受单侧腺叶切除,627例(71.3%)接受双侧腺叶切除,共涉及1 506例单侧腺叶。术后病理提示良性疾病者142例(16.2%),恶性疾病者737例(83.8%)。602侧(39.9%)甲状腺腺叶伴有甲状腺残体,其中Ⅰ型221例、Ⅱ型62例、Ⅲ型255例、Ⅳ型64...     

甲状腺细针穿刺对甲状腺相关指标的影响

[目的]探讨甲状腺细针穿刺（fine-needle aspiration,FNA）对甲状腺相关指标的影响。[方法]使用SPSS 26.0软件进行非参数检验比较甲状腺FNA前后相关指标的变化。[结果]共纳入448例患者，男性患者甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPOAb）在穿刺后第1周增长0.63 IU/mL(P=0.013)，促甲状腺素（thyroid stimulating hormone,TSH）在第5周下降27.6%(P=0.043),BRAF V600E突变组甲状腺球蛋白（thyroglobulin,Tg）在第2周升高33%(P=0.023)。具有该突变的女性Tg在第1周内升高7.1%(P=0.029)，甲状腺球蛋白抗体（thyroglobulin antibody,TgAb）在穿刺后第2周内升高、第3周内降低（P<0.05）,TgAb、TPOAb在5周后仍较穿刺前升高（P<0.05），无该突变的女性甲状腺相关指标不受FNA影响（P>0.05）。[结论]男性患者的甲状腺相关指标在行甲状腺FNA的5周后恢复至穿刺前水...     

甲状腺肿瘤干细胞研究进展

肿瘤干细胞已经成为肿瘤发病机制的研究热点，并且已经在很多肿瘤中发现并分离出了肿瘤干细胞。甲状腺肿瘤干细胞模型也已经被提出，越来越多的实验研究支持甲状腺肿瘤干细胞的存在，并认为他们可能来源于甲状腺干细胞。本文综述了目前甲状腺干细胞和甲状腺肿瘤干细胞的研究进展。     

甲状腺肿瘤干细胞研究进展

肿瘤干细胞已经成为肿瘤发病机制的研究热点,并且已经在很多肿瘤中发现并分离出了肿瘤干细胞.甲状腺肿瘤干细胞模型也已经被提出,越来越多的实验研究支持甲状腺肿瘤干细胞的存在,并认为他们可能来源于甲状腺干细胞.本文综述了目前甲状腺干细胞和甲状腺肿瘤干细胞的研究进展.     

不规则甲状腺切除治疗小儿多发性甲状腺瘤六例分析

多发性甲状腺瘤是小儿一种少见疾病，我院于１９９５年～１９９８年采用不规则甲状腺切除术治疗该病６例，取得了良好效果，总结报告如下。１　临床资料１．１　一般资料　本组共６例，男１例，女５例，年龄１０～１４岁，病程０．５～２年。多发性腺瘤位于右侧叶１例，余均为双侧。术前无并发症。术后病理诊断均给予证实。１．２　手术方法　本组病人均采用全麻。常规手术入路，紧贴甲状腺固有被膜游离甲状腺，操作在被膜内进行。处理甲状腺上极时，尽量保留正常的甲状腺组织，不结扎甲状腺上动脉。在甲状腺背侧不常规显露甲状腺下动脉，用…     

传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺癌的临床对比研究

目的比较传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺癌的临床效果。方法选取2007年1月至2012年3月期间收治的80例甲状腺癌患者,随机分为对照组和观察组,每组40例。对照组患者行传统甲状腺切除术,观察组患者行小切口甲状腺切除术。比较两组患者的手术时间、术中出血量、住院时间以及并发症发生情况。结果观察组患者的手术时间、切口长度、术中出血量、住院时间及并发症发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论小切口甲状腺切除术治疗甲状腺癌具有手术时间短、术中出血量少、切口小、住院时间短以及术后并发症少等优点,尤其是切口小,外形美观,患者满意度高,值得临床推广应用。     

甲状腺母细胞瘤1例

<正>患者男性,23岁。2022年11月因“甲状腺肿物进行性增大2个月”就诊于中国人民解放军南部战区总医院。入院体检：颈部明显增粗,气管右侧移位,甲状腺区可触及肿物大小约8 cm×6 cm,质硬,表面不光滑,无压痛,随吞咽上下活动,颈部可触及明显肿大淋巴结,融合成团。PET/CT检查提示恶性肿瘤可能,且病灶压迫气管（图1A）。入院后出现急性呼吸困难,上呼吸道梗阻,紧急行气管切开及甲状腺肿瘤切除术,术中发现双侧甲状腺弥漫性肿大质硬,鱼肉样改变,与周围组织黏连,气管受压变窄,向右侧偏移,术中切除部分甲状腺峡部肿瘤并行气管切开置管术。     

Anaplastic thyroid carcinoma, thyroid lymphoma, and metastasis to thyroid

Anaplastic thyroid carcinoma, thyroid lymphoma, and secondary metastasis to the thyroid gland are uncommon thyroid malignancies. They represent significant challenges for the surgeon owing to difficulties in diagnosis, aggressive biology, and the infrequency of their presentation. An awareness and appreciation of multimodality treatment strategies is essential for their management.     

Value of thyroid lymphography in diagnosing thyroid cancer

The results of thyroidlymphography carried out in 122 patients with thyroid cancer and 82 cases of benign tumor were analysed. Reliable thyroidlymphographic criteria of malignancy were established on the basis of a comparison of roentgenomorphologic and statistical findings. The significance of the said criteria for making timely diagnosis of cancer with concomitant adenomatosis and chronic thyroiditis is discussed.     

Salmonella thyroid abscess mimicking thyroid carcinoma

A rare case of thyroid abscess caused by Salmonella group D bacteria is reported. The clinical presentation was that of thyroid carcinoma, but diagnosis was possible only after thyroidectomy. A brief review of literature is presented.     

Anaplastic thyroid cancer and primary thyroid lymphoma: a review of these rare thyroid malignancies

BACKGROUND: To review the current literature on the treatment of anaplastic thyroid cancer (ATC) and thyroid lymphoma (TL). RESULTS: Both anaplastic carcinoma (ATC) and TL represent rare forms of thyroid cancer. ATC behaves in a highly aggressive manner, resulting in significant morbidity and mortality. Multimodality therapy consisting of both radiotherapy (RT) and chemotherapy is essential in obtaining local/regional control. Although ATC has been relatively chemo resistant, newer agents such like taxotere show promise. The role of surgery in the treatment of ATC continues to evolve, presently it should be reserved for patients who have shown an initial response to multimodality therapy and in patients in whom a complete macroscopic resection can be achieved with minimal morbidity. The successful treatment of TL currently lies in accurately diagnosing the histological subtype. Both large B-cell and mixed lymphomas are best treated with multimodality therapy consisting of CHOP combined with hyper-fractioned RT. MALT lymphomas with there more indolent course may be amenable to single modality RT or total thyroidectomy if diagnosed at an early stage IE. DISCUSSION: Although both ATC and TL are rare, it is important for surgeons to be aware of the need for multimodality therapy when treating these patients and to understand the limited role surgery plays in diagnosis and treatment.     

甲状腺乳头状癌与乳头状增生的病理研究

  目的 探讨Galectin3，CK19及Ki-67在甲状腺乳头状癌与乳头状增生中的表达，寻找有助于两者鉴别诊断的标志物。方法 运用免疫组化方法检测100例甲状腺乳头状癌、100例良性乳头状增生中Galectin3，CK19及Ki-67的表达。结果 Galectin3，CK19及Ki-67在甲状腺乳头状癌阳性表达率分别为100 %，97 %及93 %，而在乳头状增生中表达率分别为13 %，30 %及1 %，3种蛋白在乳头状癌与良性乳头状增生间差异有统计学意义（P＜0.05）。在乳头状癌中2种或3种蛋白同时阳性表达为94.3 %，而乳头状增生为0。结论 Galectin3，CK19及Ki-67是鉴别诊断甲状腺乳头状癌与乳头状增生的有用标志物，尤其联合使用更有价值。     

Previous thyroid disease and risk of thyroid cancer in Switzerland

A hospital-based case-control study of 86 cases of thyroid cancer and 317 controls was done in the Swiss Canton of Vaud. Patients with thyroid cancer tended to be better educated (odds ratio [OR] 2.1 for ≥ 14 vs. ≤ 8 years of education 95% CI 1.1–4.1) and of higher social class than controls. Cases more often had a history of benign thyroid nodules (OR 25.2, 95% CI 7.6–83.6) and non-toxic goitre (OR 5.3, 95% CI 2.5–11.2). Furthermore, patients with thyroid cancer were more likely to have resided in endemic goitre areas (OR 1.7, 95% CI 1.0–3.0) and to have had first-degree relatives affected by benign thyroid disease (OR 3.9, 95% CI 2.1–7.1). Therefore, this study offers quantitative evidence of the association between various thyroid diseases and the risk of thyroid cancer which, despite difficulties in the classification of benign and malignant thyroid diseases, is remarkably consistent in studies from different countries.