合并桥本甲状腺炎的甲状腺乳头状癌临床病理特征分析

目的:探讨合并桥本甲状腺炎(hashimoto's thyroiditis，HT)是否影响甲状腺乳头状癌(papillary thyroid carcinoma，PTC)的临床病理特征。方法:回顾性分析514例于2015年06月至2016年12月在本院行甲状腺结节切除术、术后病理证实为PTC患者的临床资料，对比分析合并或不合并HT的PTC患者的年龄、性别、肿瘤直径、血清促甲状腺素（TSH）、有无包膜侵犯、中央淋巴结转移等临床病理特征差异。结果:514例PTC病例中合并HT者74例（14.40%），不合并HT者440例（85.60%），与不合并HT组相比，合并HT组女性比例更高（91.89% vs 74.09%，P<0.05），年龄较小［（41.37±11.89）岁 vs （4４．３５±11.７９）岁，P<0.05］，肿瘤直径更小［（1.20±0.91)cm vs (1.53±1.18)cm，P<0.05］，发生包膜侵犯（18.92% vs 31.14%，P<0.05）、中央淋巴结转移（17.57% vs 30.45%，P<0.05）的比例较低，但肿瘤的多灶和多中心性方面未见显著性差异。结论:合并HT的PTC多集中于女性群体，病灶组织偏小，且PTC合并HT不会使疾病侵袭性加强。然而，合并HT患者TSH高，则可能会使PTC发生风险增加。

Clinicopathologic characteristics of papillary thyroid carcinoma with hashimoto' s thyroiditis

Objective:To investigate whether the combined hashimoto's thyroiditis (HT) affects the clinicopathological characteristics of papillary thyroid carcinoma (PTC).Methods:The clinical data of 514 patients with thyroid nodule resection from June 2015 to December 2016 and pathologically confirmed PTC were analyzed retrospectively.The age，gender，tumor size，serum thyrotropin (TSH)，capsule invasion，central lymph node metastasis and other clinical features were compared.Results:Among the 514 cases of PTC，74 cases (14.40%) were combined with HT，and 440 cases (85.60%) did not accord with HT.Compared with non-HT group，the HT group had higher proportion of women (91.89% vs 74.09%，P<0.05)，younger age (41.37±11.89 vs 44.35±11.79，P<0.05)，smaller tumor size［（1.20±0.91)cm vs (1.53±1.18）cm，P<0.05］，lower ratio of capsule invasion（18.92% vs 31.14%，P<0.05）and central lymph node metastasis（17.57% vs 30.45%，P<0.05）.But there was no significant difference in the multifocal and multicentric aspects of the tumor.Conclusion:PTC with HT more concentrated in the female population，the lesion is small，and PTC combined with HT will not make the disease aggressive.However，high TSH in HT patients may increase the risk of PTC.