桥本病合并甲状腺癌的诊断与治疗

目的分析桥本病合并甲状腺癌的临床特征、诊断、治疗及预后。方法回顾性分析1998年1月至2008年1月经病理证实为桥本病合并甲状腺癌10例的临床资料。结果术后病理诊断桥本病合并乳头状癌8例，滤泡状癌2例。术后声音嘶哑1例，有不同程度的甲状腺功能减退9例，术后均常规行甲状腺素抑制／替代治疗。结论桥本病合并甲状腺癌术前诊断困难，以手术治疗最有效，掌握其手术探查指征很重要并应按甲状腺癌根治性手术的原则施术，术后常规应用甲状腺素治疗。

Diagnosis and treatment of Hashimoto's disease accompanying with thyroid cancer

Objective To analyze clinical features, diagnosis, treatment and prognosis of Hashimoto's disease ( HD) accompanying with thyroid cancer. Methods Clinical data of 10 cases of HD accompanying with thyroid cancer admitted from Jan. 1998 to Jan. 2008 were analyzed retrospectively. Results Pathology revealed 8 cases had HD accompanying with papillary cancer and 2 cases had HD with follicle cancer. Mild hoarse voice was observed in 2 cases. Varying degree of hypothyrosis was observed in 9 cases and all patients were treated with thyroxin. Conclusions It is difficult to diagnose HD accompanying with thyroid cancer preoperatively. Knowing the indications of operative exploration of HD is very important and surgical management is the best treatment. The operation should follow the principle of radical thyriodectomy. Patients should be treated with thyroxin postoperatively.