桥本病合并甲状腺癌12例治疗观察

目的探讨桥本病合并甲状腺癌的诊断和治疗。方法回顾性分析我院1994年￣2005年收治的12例桥本病合并甲状腺癌患者的临床资料。结果桥本病合并甲状腺癌的发病率占慢性淋巴性甲状腺炎的10.1%,占甲状腺癌的8.5%,所有病人均以颈部结节就诊;并存甲状腺癌中乳头状癌8例,滤泡状癌2例,混合性癌1例,髓样癌1例。其中6例行Ⅰ期根治性手术,2例行Ⅱ期根治性手术;4例行一侧或双侧甲状腺全切或次全切术。随访3个月至10年不等,1例复发,无死亡。结论桥本病与甲状腺癌并存率高,诊断困难,因此掌握桥本病的手术探查指征十分必要,对桥本病合并甲状腺癌手术应采取根治性治疗原则。

Hashimoto's disease coexisting with thyroid cancer ,a clinical study of 12 cases

Objective To investigate the diagnosis and treament of Hashimoto's disease coexisting with thyroid cancer. Method The clinical data of 12 cases of Hashimoto's disease coexisting with thyroid cancer admitted from 1994 to 2005 in Da Hua Hospital were analyzed retrospectively. Results The morbidity of Hashimoto's disease coexisting with thyroid cancer occpupied 10.1% of hospitaled patients with Hashimoto's disease in corresponding period and 8.5% of patients with thyroid cancer. All 12 patients complained nodules in their front necks, with 8 papillary carcinoma, 2 follicular, 1 mixed type and 1 encephaloid carcinoma. Primary radical thyroidectomy was performed were in 6 cases and secondary radical thyroidectomy was performed were in 2 cases, biopsy only and thyroidectomy in 4cases. ALL 12 cases were followed up from 3 months to 10 years, 1 recurrent and no death. Conclusion There is a high incidence of coexistent thyroid neoplasm in patients with Hashimoto's disease. It's difficult to diagnose. Mastering the indications of operative exploration of Hashimoto's disease in predominant important. For the operation of the disease, the operation should be followed the principles of the radical thyroidectomy of thyroid cancer.