分化型甲状腺癌合并桥本甲状腺炎的临床分期较不活跃，复发率较低。
Well-differentiated thyroid carcinoma with concomitant Hashimoto's thyroiditis present with less aggressive clinical stage and low recurrence.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Keelung and Linkou Chang Gung Memorial Hospitals, Chang Gung University, 5, Fu-Shin St. Kweishan county, Taoyuan Hsien, Taiwan, Republic of China.
出版信息
Endocr Pathol. 2011 Sep;22(3):144-9. doi: 10.1007/s12022-011-9164-9.
Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are the most common differentiated thyroid cancers. Previous studies report that Hashimoto's thyroiditis (HT) concomitant with PTC is unusual and improves prognosis compared to classical PTC. Few previous studies address FTC concomitant with HT. In this study, we retrospectively analyzed data from one institution and compared clinical presentations and results of treatment of PTC and FTC with and without HT. In addition, studies comparing presentation and long term follow-up prognosis in classical PTC and FTC were conducted. A total of 1,788 PTC patients and 209 FTC patients underwent thyroidectomy with or without lymph node dissection and follow-up at Chang Gung Medical Center in Linkou, Taiwan. All thyroid carcinomas were pathologically classified according to World Health Organization criteria. Histological patterns of PTC were categorized as classical PTC, or PTC with HT. Follicular thyroid carcinoma patients were categorized as FTC or FTC with HT. The dataset contained a total of 1,703 PTC cases categorized as classical PTC, 85 cases of PTC with HT, 201 cases of FTC and eight cases of FTC with HT. Analysis of Classification of Malignant Tumors (TNM) stage revealed a higher percentage of classical PTC in stage IV than HT group (12.03% vs. 4.70%). Mean tumor size of classical PTC was larger than HT group. Although 42.3% of FTC cases presented with distant metastases, no cases of FTC with HT presented with distant metastasis. Cancer-specific mortality was higher in classical PTC group than in PTC with HT. There was 53.2% of FTC without HT assigned recurrent status, and six of them died of thyroid cancer. No cancer mortality or recurrence in HT with FTC. PTC and FTC with HT presented with better clinical stage and better prognosis after same therapeutic modality. In conclusions, both PTC and FTC with HT have less aggressive clinical presentation and better prognosis.
甲状腺乳头状癌（PTC）和滤泡状甲状腺癌（FTC）是最常见的分化型甲状腺癌。既往研究报道，桥本甲状腺炎（HT）合并 PTC 并不常见，与经典 PTC 相比，其预后改善。既往研究很少涉及 HT 合并 FTC。本研究回顾性分析了一家机构的数据，并比较了 HT 合并 PTC 和 FTC 的临床表现和治疗结果。此外，还比较了经典 PTC 和 FTC 的临床表现和长期随访预后。在台湾林口长庚纪念医院，共对 1788 例 PTC 患者和 209 例 FTC 患者进行了甲状腺切除术，伴或不伴淋巴结清扫术，并进行了随访。所有甲状腺癌均根据世界卫生组织（WHO）标准进行病理分类。PTC 的组织学模式分为经典 PTC 或 HT 合并 PTC。FTC 患者分为 FTC 或 HT 合并 FTC。数据集共包含 1703 例 PTC 患者，分为经典 PTC 85 例、HT 合并 PTC 85 例、FTC 201 例和 HT 合并 FTC 8 例。对恶性肿瘤（TNM）分期的分析显示，IV 期经典 PTC 的比例高于 HT 组（12.03% vs. 4.70%）。经典 PTC 的平均肿瘤大小大于 HT 组。尽管 42.3%的 FTC 患者有远处转移，但无 HT 合并 FTC 患者有远处转移。经典 PTC 组的癌症特异性死亡率高于 HT 合并 PTC 组。无 HT 合并 FTC 患者有 53.2%被判定为复发状态，其中 6 例死于甲状腺癌。HT 合并 FTC 患者无癌症死亡或复发。在接受相同治疗方法后，PTC 和 FTC 合并 HT 具有更好的临床分期和预后。结论：PTC 和 FTC 合并 HT 具有侵袭性较低的临床表现和更好的预后。
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