【摘要】：目的研究橋本甲狀腺炎(HT)合并甲狀腺癌(PTC)的臨床表現(xiàn),并進(jìn)行病理分析。方法選取溫州醫(yī)科大學(xué)附屬第三醫(yī)院收治的HT合并PTC患者30例為觀察組,另外選擇同期收治的單純HT患者70例為對照組,采用酪氨酸激酶受體(RET)免疫組化法進(jìn)行染色,對兩組臨床表現(xiàn)及病理進(jìn)行分析。結(jié)果兩組患者的臨床表現(xiàn)有一定的相似性,包括胸悶、氣短、聲嘶、頸部壓迫感和不適感。其中觀察組患者頸部壓迫感14例,頸部不適感7例,胸悶及氣短4例,聲嘶3例,甲狀腺功能減退癥2例。對照組患者頸部壓迫感31例,頸部不適感18例,胸悶及氣短12例,聲嘶6例,甲狀腺功能減退癥3例。HT合并PTC患者病理的組織形態(tài)分布最常見的為淋巴細(xì)胞浸潤、癌細(xì)胞胞質(zhì)嗜酸性、纖維化。對照組患者病理組織形態(tài)多表現(xiàn)為多樣化特點(diǎn),大部分為結(jié)節(jié)狀。觀察組主要為乳頭狀癌,且觀察組RET陽性率高于對照組,差異有統(tǒng)計學(xué)意義(P0.01)。結(jié)論 HT與PTC的臨床癥狀和病理基礎(chǔ)具有一定的相似性,其中HT是引發(fā)患者發(fā)生PTC的重要病因,對HT患者積極的治療,可有效防止疾病的惡化,臨床應(yīng)當(dāng)予以重視。
[Abstract]:Objective to study the clinical manifestations of Hashimoto's thyroiditis (HT) complicated with thyroid carcinoma (PTC) and to make pathological analysis. Methods Thirty patients with HT combined with PTC were selected as observation group and 70 patients with simple HT as control group. Tyrosine kinase receptor (RET) immunocytochemistry method was used to detect tyrosine kinase receptor (RET). The clinical manifestations and pathology of the two groups were analyzed. Results the clinical manifestations of the two groups were similar, including chest tightness, shortness of breath, hoarseness, neck pressure and discomfort. In the observation group, there were 14 cases of cervical compulsion, 7 cases of neck discomfort, 4 cases of chest tightness and shortness of breath, 3 cases of hoarseness and 2 cases of hypothyroidism. In the control group, there were 31 cases of cervical compulsion, 18 cases of neck discomfort, 12 cases of chest tightness and shortness of breath, 6 cases of hoarseness, 3 cases of hypothyroidism and 3 cases of hypothyroidism. The most common histopathologic distribution of HT with PTC was lymphocytic infiltration. Cancer cell cytoplasm eosinophilic, fibrosis. In the control group, the histopathologic features were diversified, most of which were nodular. The positive rate of RET in the observation group was higher than that in the control group (P0.01). Conclusion the clinical symptoms and pathological basis of HT and PTC are similar, and HT is an important cause of PTC in patients. Active treatment of HT patients can effectively prevent the deterioration of the disease, and should be paid attention to clinically.
【作者單位】： 溫州醫(yī)科大學(xué)附屬第三醫(yī)院內(nèi)分泌科;
【分類號】：R581.4;R736.1

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