Pazaitou-Panayiotou Kalliopi, Perros Petros, Boudina Maria, Siardos George, Drimonitis Apostolos, Patakiouta Frideriki, Vainas Iraklis
Department of Endocrinology-Endocrine Oncology, Theagenion Cancer Hospital, 2, Alexandrou Simeonidi Street, 54007 Thessaloniki, Greece.
Eur J Endocrinol. 2008 Dec;159(6):799-803. doi: 10.1530/EJE-08-0468. Epub 2008 Sep 26.
Thyroid carcinoma has been reported in patients operated for different types of hyperthyroidism and the probability of a hot nodule being malignant seems to be low. The aim of the present study was to explore the relationship between thyroid cancer, hyperthyroidism and outcome in a large cohort of patients who presented to a tertiary cancer centre in Northern Greece.
Among 720 patients treated for thyroid cancer, 60 had a concomitant diagnosis of hyperthyroidism due to Graves' disease (n=14), solitary autonomous adenoma (n=17), or multinodular goiter (n=29). Adverse prognostic factors were common in patients with a previous history of hyperthyroidism at the time of diagnosis of thyroid cancer, including cases where the cancer was discovered coincidentally after thyroid surgery for hyperthyroidism and cases where tumor size was more than 10 mm.
In 10 out of 17 patients with hyperthyroidism due to solitary autonomous adenomas, the tumor was located within the hot nodule and two of these patients developed local and distant metastases and died from the disease 4 and 15 years after thyroidectomy.
Clinicians managing patients with hyperthyroidism need to be aware of the possible increased risk of thyroid cancer in this patient group.
在接受不同类型甲亢手术的患者中曾有甲状腺癌的报道，热结节为恶性的可能性似乎较低。本研究的目的是在一大群前往希腊北部一家三级癌症中心就诊的患者中，探讨甲状腺癌、甲亢与预后之间的关系。
在720例接受甲状腺癌治疗的患者中，60例同时诊断为因格雷夫斯病（n = 14）、孤立性自主腺瘤（n = 17）或多结节性甲状腺肿（n = 29）导致的甲亢。在甲状腺癌诊断时，既往有甲亢病史的患者中不良预后因素较为常见，包括甲亢甲状腺手术后偶然发现癌症的病例以及肿瘤大小超过10毫米的病例。
在17例因孤立性自主腺瘤导致甲亢的患者中，有10例肿瘤位于热结节内，其中2例患者发生局部和远处转移，并在甲状腺切除术后4年和15年死于该疾病。
管理甲亢患者的临床医生需要意识到该患者群体中甲状腺癌风险可能增加。
