Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
J Surg Oncol. 2012 Aug 1;106(2):169-73. doi: 10.1002/jso.23070. Epub 2012 Feb 21.
In our institution, patients with medullary thyroid carcinoma (MTC) concurrent with nodular goiter (NG) have a nearly 100% survival rate, but the reasons and characteristics are unclear.
Eighty patients with MTC who underwent surgery in our center between 1971 and 2011 were reviewed.
A total of 21 MTC/NG and 59 MTC only patients were identified. The stage of the two groups had no significant difference (P = 0.13). The MTC/NG group had lower preoperative serum calcitonin (CT) levels (914.7 ng/L vs. 1162.6 ng/L, P = 0.003), lower postoperative serum CT levels (371.4 ng/L vs. 582.5 ng/L, P < 0.001), lower carcinoembryonic antigen levels (18.3 ng/ml vs. 130.5 ng/ml, P < 0.001), a lower propensity toward lymph node metastasis (40.0% vs. 66.7%, P = 0.07), and a lower proportion of multifocality (19.1% vs. 42.4%, P = 0.06), capsular invasion (9.5% vs. 25.4%, P = 0.21), and vascular invasion (4.8% vs. 10.1%, P = 0.67). The mean tumor diameter of the two groups was similar (20.3 mm vs. 22.1 mm, P = 0.6). Overall 15-year survival in MTC/NG versus MTC only groups was 100% versus 57.0% (P = 0.03).
MTC with NG is an indolent disease and has an excellent prognosis. The only independent predictor of survival was the TNM stage of disease.
在我们的机构中，同时患有甲状腺髓样癌（MTC）和结节性甲状腺肿（NG）的患者几乎达到 100%的存活率，但原因和特征尚不清楚。
回顾了 1971 年至 2011 年间在我们中心接受手术的 80 例 MTC 患者的临床资料。
共发现 21 例 MTC/NG 和 59 例 MTC 仅患者。两组的分期无显著差异（P=0.13）。MTC/NG 组术前降钙素（CT）水平较低（914.7ng/L 比 1162.6ng/L，P=0.003），术后 CT 水平较低（371.4ng/L 比 582.5ng/L，P<0.001），癌胚抗原（CEA）水平较低（18.3ng/ml 比 130.5ng/ml，P<0.001），淋巴结转移倾向较低（40.0%比 66.7%，P=0.07），多灶性比例较低（19.1%比 42.4%，P=0.06），包膜侵犯率较低（9.5%比 25.4%，P=0.21），血管侵犯率较低（4.8%比 10.1%，P=0.67）。两组肿瘤平均直径相似（20.3mm 比 22.1mm，P=0.6）。MTC/NG 组与 MTC 仅组 15 年总生存率分别为 100%和 57.0%（P=0.03）。
MTC 合并 NG 是一种惰性疾病，预后良好。唯一独立的生存预测因素是疾病的 TNM 分期。
