桥本甲状腺炎合并甲状腺疑似恶性结节的临床病理特点

目的]研究桥本甲状腺炎0aashimoto’sthyroiditis，HT）合并甲状腺疑似恶性结节的临床病理特点，总结良、恶性结节的不同特点，恶性结节的临床诊断要点及手术治疗经验。方法]回顾性分析2009年1月至2011年12月我院收治的58例HT合并甲状腺疑似恶性结节的临床病理资料。比较恶性结节及良性结节在性别构成、年龄、结节数目、有无钙化、甲状腺激素及甲状腺抗体水平上的差异。结果]HT合并恶性结节组平均年龄明显低于HT合并良性结节组（P〈0．05），结节钙化比例明显高于HT合并良性结节组（P〈0．05），术前促甲状腺素（TSH）、抗甲状腺球蛋白抗体（Anti-TG）水平明显高于HT合并良性结节组（P〈O．05）。两组之间在术前FT3、FT4、抗甲状腺过氧化物酶抗体（Anti—TPO）水平上、性别比例、及病灶数目上的差异无统计学意义（P〉0．05）。结论]术前诊断需重视年轻患者及结节有钙化者，其恶性的可能性较大。血清TSH及Anti—TG水平的升高可能与结节恶变有关。

The Clinico-pathological Features of Suspected Malignant Nodules Associated with Hashimoto＇s Thyroiditis-Diagnosis

Objective]To analyze the clinical and biological characteristics of suspected malignant thyroid nodules associated with Hashimoto thyroiditis.To summarize different characteristics of benign and malignant nodules, diagnosis and treatment of suspected malignant nodules associated with Hashimoto＇s thy roidids. Methods]Surgically and pathologically confirmed, 58 cases of suspected malignant thyroid nodules associated with Hashimoto＇s thyroiditis were retro spectively analyzed with clinical and pathological data. The differences of gender, age, number of nodules, calcification, and thyroid hormone and thyroid an tibodies levels between malignant and benign nodules were compared from January 2009 to December 2011. Results] The average age of malignant thyroid nodules coexisting with HT group was significantly lower than that of benign nodules coexisting with HT group（P〈0.05）. The proportion of nodular calcifi cation in malignant thyroid nodules coexisting with HT group was significantly higher than that in benign nodules coexisting with HT group（P〈0.05）. Pre operative TSH and antiTG levels in malignant thyroid nodules coexisting with HT group were significantly higher than that in benign nodules coexisting with HT group. Preoperative FT3, FT4, antiTPO levels, sex ratio and number of lesions between the two groups were not statistically significant. Conclu sions] The key point of preoperative diagnosis： patients of malignant thyroid nodules coexisting with HT are associated with youth, calcified nodules, elevated serum TSH and antiTG levels.