Gulcelik Mehmet Ali, Gulcelik Nese Ersoz, Dinc Soykan, Kuru Bekir, Camlibel Mithat, Alagol Haluk
Department of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
J Surg Oncol. 2006 Jul 1;94(1):35-9. doi: 10.1002/jso.20508.
The incidence of hyperthyroidism among thyroid malignancy varies greatly depending on the geographical area and iodine intake. The aim of the study was to evaluate the association of hyperthyroidism and thyroid cancer (TC) in an iodine deficient area.
Medical records of 422 patients who underwent operation for TC between 1992 and 2000 in Ankara Oncology Hospital were reviewed. The characteristics of TC patients with hyperthyroidism were analyzed in respect to gender, age, histopathological type, thyroid function status, tumor size, extrathyroidal invasion, local recurrences, distant metastasis, AMES and MACIS scoring.
In the present patient series, among 422 patients with TC, hyperthyroidism was found in 12 patients (2.8%). None of the patients had Graves' disease. Of 12 patients with hyperthyroidism, 9 patients had papillary carcinoma, 1 patient had follicular carcinoma and 2 patients had follicular variant of papillary carcinoma. The tumor was in the active nodule in 5 patients.
The existence of hyperthyroidism among patients with differentiated TC is a clinical entity. Patients with hyperthyroidism and nodules require a careful approach in order to establish or exclude the possibility of TC especially in formerly iodine deficient areas.
甲状腺恶性肿瘤中甲状腺功能亢进症的发病率因地理区域和碘摄入量的不同而有很大差异。本研究的目的是评估碘缺乏地区甲状腺功能亢进症与甲状腺癌（TC）之间的关联。
回顾了1992年至2000年在安卡拉肿瘤医院接受TC手术的422例患者的病历。从性别、年龄、组织病理学类型、甲状腺功能状态、肿瘤大小、甲状腺外侵犯、局部复发、远处转移、AMES和MACIS评分等方面分析了甲状腺功能亢进症TC患者的特征。
在本患者系列中，422例TC患者中有12例（2.8%）患有甲状腺功能亢进症。所有患者均无格雷夫斯病。在12例甲状腺功能亢进症患者中，9例为乳头状癌，1例为滤泡状癌，2例为乳头状癌滤泡变异型。5例患者的肿瘤位于活性结节中。
分化型TC患者中存在甲状腺功能亢进症是一种临床实体。甲状腺功能亢进症和结节患者需要谨慎处理，以便确定或排除TC的可能性，尤其是在既往碘缺乏地区。
