原发性甲状腺鳞状细胞癌42例诊治分析

目的：探讨原发性甲状腺鳞状细胞癌的临床特征和综合治疗效果。方法：回顾性分析我院1964年-2006年收治甲状腺鳞状细胞癌患者42例,22例行原发灶完整切除＋患侧侧颈或区域颈淋巴结清扫,其中病理证实有淋巴结转移者18例;13例行原发灶扩大切除;姑息切除术7例,其中2例同时行气管切开。术后行根治性局部放疗37例,剂量为60—75Gy。结果：患者总的半年生存率为52．3％（22／42）,1年生存率为荔．6％（12／42）,2年生存率为19．0％（8／42）,中位生存期为10．1个月。结论：甲状腺鳞状细胞癌是罕见的恶性肿瘤,病情发展迅速,预后差。早期发现并进行扩大根治性手术,并辅以足量放疗,能最大限度提高生存率。     

原发性甲状腺鳞状细胞癌27例分析

目的：探讨原发性甲状腺鳞状细胞癌的临床特征和影响该病预后的因素。方法：收集我院1969年至2000年问收治的31例原发性甲状腺鳞状细胞癌病例。选取随访资料完整的27例，对患者性别、年龄、肿物直径、颈淋巴结转移与否、术式、有否肉眼肿瘤残余、放疗、化疗情况等参数，采用SPSS10.0统计软件包进行统计学分析。生存率计算采用寿命表法，生存率的比较采用Kaplan—Meier法进行Log—rank生存分布检验。对于单因素分析有意义的变量．通过变量逐步引入的方法进入COX回归模型，确立影响生存预后的独立因素。结果：原发性甲状腺鳞状细胞癌发病率低，恶性度高．手术方式和放疗是影响该病预后的因素。结论：对于原发性甲状腺鳞状细胞癌患者，建议采取甲状腺癌广泛切除术，术后局部足量放疗。     

原发性甲状腺鳞状细胞癌：附8例临床分析

原发性甲状腺鳞状细胞癌罕见,国内外文献仅有少数报道。我院1964年至1989年间收治8例,现报道如下。 临床资料 1964年至1989年我院共收治甲状腺恶性肿瘤801例,其中原发性甲状腺鳞癌8例,约占1％。8例均为男性。年龄45岁～67岁,平均55.4岁。病史最短1个月,     

原发性甲状腺鳞状细胞癌27例分析

目的:探讨原发性甲状腺鳞状细胞癌的临床特征和影响该病预后的因素。方法:收集我院1969年至2000年间收治的31例原发性甲状腺鳞状细胞癌病例。选取随访资料完整的27例,对患者性别、年龄、肿物直径、颈淋巴结转移与否、术式、有否肉眼肿瘤残余、放疗、化疗情况等参数,采用SPSS10.0统计软件包进行统计学分析。生存率计算采用寿命表法,生存率的比较采用Kaplan-Meier法进行Log-rank生存分布检验。对于单因素分析有意义的变量,通过变量逐步引入的方法进入COX回归模型,确立影响生存预后的独立因素。结果:原发性甲状腺鳞状细胞癌发病率低,恶性度高,手术方式和放疗是影响该病预后的因素。结论:对于原发性甲状腺鳞状细胞癌患者,建议采取甲状腺癌广泛切除术,术后局部足量放疗。     

原发性甲状腺鳞状细胞癌4例报告

本文报道4例原发性甲状腺鳞状细胞癌,男、女各2例,年龄44—59岁(平均53.5岁)。肿瘤呈浸润性迅速生长。患者短期内出现发声嘶哑及呼吸困难。本病恶性度高,预后极差,对放疗及化疗不敏感。4例均在术后2月内死亡。病理切片中可见滤泡上皮鳞状上皮化生与鳞状细胞癌并存,提示原发性甲状腺鳞状细胞癌是由化生的鳞状上皮恶变而来。     

甲状腺鳞状细胞癌3例报告

例1:患者,男,62岁,声嘶8个月以上,吞咽困难伴饮水呛咳两个月以上,发现颈部肿块1个月有余,于2003年9月7日入院。喉镜检查,双侧声带固定于旁正中位,发声及吸气声带不运动。B超示甲状腺内实质性病变,血流信号丰富。CT示甲状腺癌累及气管及食道上段,可能累及声门。ECT示双侧甲状腺总体吸锝功能减低,MIBI 阳性显像阴性。细胞学穿刺示,1)亚急性甲状腺炎;2)部分细胞增生明显,合并甲状腺癌待排。2003年9月12日行甲状腺癌姑息切除,术中见双侧甲状腺质硬,固定, 大小为6×3×2cm³,并侵犯颈前肌群,与气管、食管关系密切,侵犯右侧颈血管鞘。术后病检是甲状腺鳞状细胞癌(中分化)。术后呼吸困难改善,但进食仍困难,术后食管吞碘示会厌病变致碘水进入食管困难,但大部分进入气道内。术后两个月因局部肿瘤复发及恶液质死亡。     

原发性甲状腺鳞状细胞癌临床病理分析

目的:探讨原发性甲状腺鳞状细胞癌的临床病理特点、病理诊断及鉴别诊断.方法:复习5例原发性甲状腺鳞状细胞癌的临床病理资料,采用HE染色、免疫组化技术和电镜技术进行观察分析.结果:5例中3例为女性.发病中位年龄55岁,术后平均生存3～7个月.临床主要表现为颈部肿块、声嘶、呼吸困难和吞咽困难;光镜下病变多呈高分化鳞状细胞癌,广泛浸润至周围组织;广谱细胞角蛋白(CKpan)、细胞角蛋白19(CK19)5例均弥漫强阳性,细胞增殖标记抗体(Ki-67)的阳性表达率为30%～50%.甲状腺转录因子-1(TTF1)、甲状腺球蛋白(TG)和外套层细胞淋巴瘤标记(CD5)均不表达;超微结构示瘤细胞有异形性,胞质内可见张力原纤维丝,细胞间有发育良好的桥粒.结论:原发性甲状腺鳞状细胞癌是罕见的高度恶性肿瘤,侵袭性强,诊断时应排除继发性鳞状细胞癌以及其他类型甲状腺病变伴鳞化.     

原发性甲状腺鳞状细胞癌1例

患者, 女性, 51岁.主因声音嘶哑6个月, 右侧偏头痛2个月, 呼吸困难20余天, 于2003年12月8日入院.     

甲状腺原发性鳞状细胞癌二例

病例 1,男 ,5 8岁。因右颈部包块 5个月 ,渐增大伴声音嘶哑及吸气时呼吸困难而入院。查体 :右颈前可扪及 6.5× 4.8ｃｍ大小之硬性包块 ,随吞咽上下移动 ,有触痛。Ｂ超检查示 :右甲状腺实性占位性病变。术前诊断为右侧甲状腺瘤 ,术中见肿块位于右侧甲状腺下极与锁骨上及气管粘连 ,大小约 5 .0×4.5× 3 .0ｃｍ ,成片块增厚 ,质硬 ,包膜不完整。行右侧甲状腺全切除术。术后病理诊断 :右侧甲状腺原发性鳞状细胞癌Ⅱ级。未接受放、化疗 ,随访三年余情况良好。病例 2 ,男 ,5 5岁。因左颈部包块 7月 ,增长迅速伴声音嘶哑 3个月入院。查体 :甲状腺…     

甲状腺原发性鳞状细胞癌5例报告

甲状腺原发性鳞状细胞癌５例报告詹又华张吉吉人张莹甲状腺原发性鳞状细胞癌是一种少见的高度恶性肿瘤。我院自１９６８年５月至１９９４年５月，共收治本病５例，占同期甲状腺恶性肿瘤的２．５％。现报告如下。临床资料１．性别与年龄男２例，女３例。年龄４６岁～６８岁...     

原发性甲状腺鳞状细胞癌2例病例报道并文献复习

原发性甲状腺鳞状细胞癌是一种临床罕见的甲状腺恶性肿瘤,其恶性程度高,侵袭力强,临床上早期诊断困难,根治手术难度较大,预后极差,中位生存期约6个月。治疗上以手术为主。对于不能行手术治疗的患者,可行放射治疗,放射治疗在一定程度上可提高局控率,化疗方面没有显示明显的优势。     

Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan.

We retrospectively analyzed the records of 703 cases of oral squamous cell carcinoma (SCC) collected from 1 January 1985 to 31 December 1996 at a teaching hospital in southern Taiwan, to identify the characteristics of patients and factors associated with survival. There was an overwhelming male predominance (male:female = 15:1). The mean age of the patients was 52. The peak age of oral SCC patients declined from 50 to 59 years in the first six years (1985-1990) and 40-49 years in the last six years (1991-1996). The most common site of oral SCC was the buccal mucosa with 263 patients (37.4%). Most patients (346/703 patients; 49.2%) had stage III cancer. The most common site of occurrence of SCC was the buccal mucosa (263/703 patients; 37.4%), both overall and in patients who chewed betel quid alone or in combination with cigarette smoking and/or alcohol consumption; the tongue was the most common site among patients without any oral habits (18/48 patients; 37.5%). Furthermore, the age of occurrence was on average 6-12 years younger among patients who chewed betel quid than in those who did not. Of the 703 patients, 496 received treatment with surgery, chemotherapy, and/or radiation therapy. Of these, 209 (42.1%) died. The cancer stage significantly influenced mortality: the 5-year survival rate in patients treated from 1985 to 1991 was 72% in those with stage I, 38.9% in those with stage II, 26.7% in those with stage III, and 11.8% in those with stage IV cancer. Six variables were found to significantly affect survival: tumor size, lymph node involvement, surgery, betel quid chewing, staging, and histological differentiation (all p < 0.05, Kaplan-Meier analysis with log rank test). Of these, surgery and cancer stage independently affected survival in a proportional hazards model (both p < 0.0001). Therefore, the early surgical intervention, and the withdrawal from oral habits, especially betel quid chewing, will be advantageous to patients' survival.     

Primary squamous cell carcinoma of the thyroid.

AIMS: To investigate the clinical features and treatment protocol of squamous cell carcinoma of the thyroid (SCCT). METHOD: Clinical records of four SCCT patients treated during 1985--99 were retrospectively reviewed and evaluated. RESULTS: Two patients who underwent surgical excision plus radiotherapy died of local tumour recurrence, 6 and 13 months, respectively, post-operatively. One who accepted surgery only died 4 months later of respiratory distress. The fourth patient who had radical surgery coupled with radiotherapy and chemotherapy was disease-free at 26-month follow-up. CONCLUSION: SCCT is a very rare but highly malignant carcinoma. Early diagnosis and an aggressive radical surgery portend a better prognosis. Radiotherapy and chemotherapy are secondary applicable methods for the patients with certain condition.     

Primary squamous cell carcinoma of the submandibular salivary gland

Malignant tumors of the submandibular salivary glands are rare in occurrence, among which primary squamous cell carcinoma of the submandibular salivary gland is unusual and the documented evidence is 2 to 5% among malignant tumors A case of primary squamous cell carcinoma of submandibular salivary gland is being presented for its rarity     

原发性甲状腺鳞癌7例临床分析

对7例原发性甲状腺鳞癌患者的临床资料进行回顾性分析，57.1%(4/7)患者死于局部复发，42.8%(3/7)死于远地转移，手术＋放疗3例无局部复发、且生存时间较长。作者认为手术＋放疗治疗甲状腺鳞癌有望减少局部复发。     

原发性甲状腺恶性淋巴瘤28例临床分析

背景与目的：原发性甲状腺恶性淋巴瘤很少见,其临床治疗方案和预后评判尚无统一标准。本文探讨原发性甲状腺恶性淋巴瘤的临床表现、诊断、治疗和影响预后的主要因素。方法：回顾28例原发性甲状腺恶性淋巴瘤患者的一般临床资料、临床病理分型、治疗方法、组织病理分型,并结合随访资料进行分析。结果：不足40岁组3例均为腺内型;40～60岁组9例中7例为腺内型,2例为腺外型;60岁以上组16例中,7例为腺内型,9例为腺外型。有随访的24例原发性甲状腺恶性淋巴瘤的中位随访期3年(1～14年),15例腺内型中2例死亡(13．33％),而9例腺外型中6例(66．67％)死亡;20例颈部肿物被完全切除者均生存达1年以上,而4例肿物未能彻底切除者均生存不足1年。肿瘤组织病理分型属B大细胞型的44例中,仍生存8例,其最长生存期达68个月;而滤泡Ⅱ型的3例均死于本病,最长生存期仅18个月。本组病例的1年生存率为61.54％,3年生存率为43．31％,5年生存率为27．35％。结论：原发甲状腺恶性淋巴瘤肿物彻底切除辅以治疗量的放疗和化疗是较合理的治疗方法。发病时的年龄、肿瘤的临床分型(肿瘤侵犯程度)和肿物切除是否彻底是影响原发甲状腺恶性淋巴瘤预后的主要因素;肿瘤的组织病理分型与预后无关。     

Primary squamous cell carcinoma of the thyroid: immunohistochemical profile and literature review

BACKGROUND: Squamous cell carcinoma accounts for 1% of primary thyroid malignancies and is characterized by a rapidly unfavorable outcome. CASE PRESENTATION: A 64-year-old woman presented with a painless mass in the left neck, coexisting with thyroid goiter. Total thyroidectomy with lymphadenectomy was performed and a primary thyroid squamous cell cancer was confirmed histologically after excluding any other possible primary malignancies. The tumor's immunohistochemical profile was explored using a large panel of antibodies. The tumor featured a positive immunoreaction to cytokeratins 7-19 and to squamous cell carcinoma antigen. Low-molecular-weight cytokeratins 5-6 and epithelial membrane antigen were also expressed. The neoplasm's proliferative index (Mib1) was 60%. No immunostaining was detected for cytokeratins 10-20, thyroglobulin, TTF-1, CD5, galectin-3 or p53. CONCLUSIONS: This case of primary thyroid squamous cell carcinoma immunohistochemically profiled using a large panel of immunoreactions may offer useful information on the histological differentiation of thyroid squamous cell carcinoma from other (uncommon) thyroid carcinomas and the distinction between primary and secondary thyroid cancers.     

儿童甲状腺癌14例临床分析

目的 探讨儿童甲状腺癌的临床特点,诊断原因,治疗及预后。方法 回顾性分析１９７７～１９９７年 治的１４岁以下儿童甲状腺癌１４例,按１９８９年国际抗癌联盟（ＵＩＣＣ）临床病理分期标准复习病理和分期。结果 乳头状癌１２例（８３．３％）,滤泡状癌２例（１６．７％）。１期１３例,２期１例。直接误诊７例。单侧胜颈清扫术１１例,双侧颈清扫术２例,姑息性甲状腺次全切除,术后病理示颈淋巴结转移阳性者１２例（８５．