甲状腺癌并存淋巴细胞性甲状腺炎的临床病理特点：附129例分析

目的:探讨甲状腺癌(TC)合并淋巴细胞性甲状腺炎(LT)的临床病理特点。方法:回顾性分析87例单纯TC(TC组)及129例TC合并LT患者临床病理资料(TC合并LT组),后者包括40例(31.0%)合并桥本氏甲状腺炎(HT),81例(62.8%)合并慢性淋巴细胞性甲状腺炎(CLT),8例(6.2%)同时合并HT与CLT。结果:所有患者均行手术治疗,根据患者病变情况分别行单侧腺叶切除、次全切除、全切除以及不同范围的淋巴结清扫术。129例TC合并LT患者中,仅1例(0.8%)为甲状腺髓样癌(MTC),其余(99.2%)均为甲状腺乳头状癌(PTC)。与TC组比较,TC合并LT组女性、微小癌、单叶受累、颈淋巴结阴性比率均明显增加,而病灶最大径明显减小(均P0.05);在TC合并LT组中,并CLT患者与合并HT患者各项临床病理指标均无统计学差异(均P0.05)。结论:与LT并存的TC以PTC多见,且多为女性,LT可能对TC原发灶生长及腺内、颈部淋巴结转移有抑制作用;TC合并CLT与合并HT的临床病理特征相似。

Clinicopathologic characteristics of thyroid carcinoma with concomitant lymphocytic thyroiditis: analysis of 129 cases

Objective: To investigate the clinicopathologic characteristics of thyroid carcinoma (TC) with concomitant lymphocytic thyroiditis (LT). Methods: The clinical data of 87 patients with TC alone (TC group) and 129 patients with TC and concomitant LT (TC plus LC group) were retrospectively analyzed, and the latter included 40 cases had concomitant Hashimoto''s thyroiditis (HT), 81 cases had concomitant chronic lymphocytic thyroiditis (CLT) and 8 cases had concomitant HT and CLT. Results: All patients received surgical treatment that included unilateral thyroid lobectomy, and sub-total or total thyroidectomy with lymph node dissection of different scopes according to the disease conditions of the patients. In patients with TC and concomitant LT, only one case (0.8%) was medullary thyroid carcinoma (MTC), and all the remaining cases were papillary thyroid carcinoma (PTC). In TC plus LC group compared with TC group, the proportions of female gender, microcarcinoma, unilateral lobe involvement and negative cervical lymph node were significantly increased, while the maximum diameter of tumor was significantly decreased (all P<0.05). Among patients in TC plus LC group, there was no significant difference in any studied clinicopathologic variables between cases with concomitant HT and concomitant CLT (all P>0.05).Conclusion: TC that coexists with LT is dominated by PTC, and the majority of cases are female gender. LT may possibly inhibit metastasis of TC within the gland and to the lymph nodes, and the clinicopathologic features are similar between TC combined with CLT and TC combined with HT.