甲状腺乳头状癌伴桥本甲状腺炎患者的临床病理特征分析

Clinicopathological characteristics of patients with coexisting papillary thyroid carcinoma and Hashimoto's thyroiditis

关键词:  甲状腺乳头状癌  桥本甲状腺炎  免疫组织化学

Key words:  papillary thyroid carcinoma  Hashimoto's thyroiditis  immuno-histochemistry

摘要:

目的 比较分析甲状腺乳头状癌（papillary thyroid carcinoma, PTC）伴发桥本甲状腺炎（Hashimoto's thyroiditis, HT）的临床病理学特征。方法 回顾性观察2015年1月至2017年12月行甲状腺癌根治手术的632例甲状腺癌患者资料，比较分析PTC伴有和不伴HT患者的临床病理学特征。结果 在632例甲状腺癌中，614例（97.15%）为PTC，其中120例（19.0%）伴有HT；与其他组织学亚型相比，PTC与HT显著相关（P<0.001）；与不伴有HT的PTC的患者相比，伴有HT的PTC患者较年轻（P=0.008），女性比例较高（88.3% vs 73.1%，P<0.001），TSH、TGAb和TPOAb水平较高（P<0.001），肿瘤直径较小（P=0.034），Ki67阳性率及表达强度较高（P<0.05）。结论 与不伴HT的PTC患者相比，伴有HT的PTC患者较年轻，肿瘤较小，Ki67表达较强。

Abstract:

Objective To analyze the clinicopathological characteristics of patients with coexisting papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis (HT). Methods The clinicopathological data of 632 patients with PTC were retrospectively reviewed, including 614 PTC cases (97.15%) without HT and 120 PTC cases complicated with HT (19.0%). Results Compared to other pathological subtypes of PTC, there was a closer association between PTC and HT (P<0.001). Patients with coexisting PTC and HT (PTC+HT group) were significantly younger than patients with PTC alone (PTC group) (P=0.008). There were more women in the PTC+HT group than in the PTC group (88.3% vs 73.1%, P<0.001). TSH, TGAb and TPOAb levels were significantly higher in the PTC+HT group than in the PTC group (P<0.001). In addition, tumor diameter was smaller inthe PTC+HT group than in the PTC group (P=0.034). Immunohistochemical analysis revealed that patients in the PTC+HT group had a higher positive rate and expression intensity of Ki67 than patients in the PTC group（P<0.05）. Conclusion Patients with coexisting PTC and HT are younger, have smaller tumor diameters and higher positive rates and expression intensity of Ki67 than patients with PTC alone.