结节性甲状腺肿合并甲状腺微小癌临床病理分析

目的探讨结节性甲状腺肿合并甲状腺微小癌（TMC）的临床病理特征。方法回顾性分析42例结节性甲状腺肿合并TMC的临床表现及病理特征，重新免疫组化CK19、galectin-3及bcl-2检测。结果303例结节性甲状腺肿中合并TMC42例（13．9％）；女29例，男13例；平均33．5岁；癌肿均〈0．9cm；术前诊断10例（23．8％），疑似诊断18例（42．9％），漏诊14例（33．3％）；随访2—7年，42例均健在，均未复发或转移。结论结节性甲状腺肿合并TMC发病率较高，好发于中年女性，预后良好，临床征象多无特异性，确诊依靠病理，应常规术中快速病理。

Clinicopathologic features of nodular goitre with thyroid microcarcinoma

Objective To study the clinicopathology characteristics of nodular goitre with thyroid mierocarcinoma（TMC） in order to improve its diagnostic and therapeutic accuracy. Methods A restrospective analysis was done on the clinical and pathologic meterrials of 42 cases of nodular goitre with TMC. All HE slides were reexamined and immunostains for CK19, galectin-3, and bcl-2 were performed. Results In total 303 cases of nodular goitre,42 cases had coexistent TMC. There were 29 females and 13 males with median age of 33.5 years old. All tumor diameter was counted for 〈 0. 9 cm. Microcaleification was seen in 18 cases（ 42. 9% ）in ultrasonic exam and CT scans. Follow-up data showed that 42 patients were all alive with no evidence of recurrence or metastasis for 2 to 7 years by July 2008. Conclusion There were high incidence of TMC in nodular goitre population and no special clinical characteristics in Coexistent nodular goitre with TMC. Microealcification in nodular goitre in the group of middle-aged women increase the likelihood of the diagnosis. But the diagnosis depends on pathology.