甲状腺乳头状癌合并桥本甲状腺炎的临床病理特征
[Clinico-pathological features of papillary thyroid cancer coexistent with Hashimoto's thyroiditis].
作者信息
Molnár Sarolta, Győry Ferenc, Nagy Endre, Méhes Gábor, Molnár Csaba
机构信息
Patológiai Intézet, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen, Nagyerdei krt. 98., 4032.
Sebészeti Intézet, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen.
出版信息
Orv Hetil. 2017 Feb;158(5):178-182. doi: 10.1556/650.2017.30647.
INTRODUCTION AND AIM
Former studies suggest the frequent coexistence of Hashimoto's thyreoditis with papillary thyroid cancer, frequently featured by multifocal carcinogenesis but lower clinical stages compared to thyroid cancers lacking thyroiditis. We examined the clinico-pathological correlations between Hashimoto's thyroditis and papillary thyroid cancer in our region in the North-Eastern part of Hungary.
PATIENTS AND METHOD
We included a total of 230 patients with papillary thyroid cancer who underwent thyroid surgery at the Surgical Department of the University of Debrecen. Patients' sex, age, multifocality of thyroid cancer and clinical stage were evaluated.
RESULTS
Cases included 40 patients (17.4%) with (4 male, 36 female) and 190 (82.6%) patients without HT (44 male, 146 female). Hashimoto's thyroiditis related thyroid cancer was almost exclusively associated with the papillary histological type. Multifocality of papillary cancer was significantly more frequent with coexisting Hashimoto's thyroiditis (16/40; 40.0%) compared to cases uninvolved (45/190; 23.7%; p = 0.034). In contrast, lymph node metastasis was significantly less frequent among patients with Hashimoto's thyroiditis (4 pN1 [36.4%]; 7 pN0 [63.6%]) then without it (34 pN1 [82.9%]; 7 pN0 [17.1%]; p = 0.002).
CONCLUSION
Higher frequency and multifocality of papillary thyroid cancer might be the consequence of preexisting Hashimoto's thyroiditis to be considered as a preneoplastic stimulus supporting carcinogenesis, though the exact pathomechanism of this correlation is not clear yet. Orv. Hetil., 2017, 158(5), 178-182.
引言与目的
既往研究表明,桥本甲状腺炎常与甲状腺乳头状癌并存,其特征通常为多灶性癌变,但与无甲状腺炎的甲状腺癌相比,临床分期较低。我们研究了匈牙利东北部地区桥本甲状腺炎与甲状腺乳头状癌之间的临床病理相关性。
患者与方法
我们纳入了德布勒森大学外科接受甲状腺手术的230例甲状腺乳头状癌患者。评估了患者的性别、年龄、甲状腺癌的多灶性及临床分期。
结果
病例包括40例(17.4%)患有桥本甲状腺炎的患者(4例男性,36例女性)和190例(82.6%)无桥本甲状腺炎的患者(44例男性,146例女性)。桥本甲状腺炎相关的甲状腺癌几乎仅与乳头状组织学类型相关。与无桥本甲状腺炎的病例相比,并存桥本甲状腺炎时乳头状癌的多灶性明显更常见(16/40;40.0%),而无桥本甲状腺炎的病例为(45/190;23.7%;p = 0.034)。相反,桥本甲状腺炎患者的淋巴结转移明显少于无桥本甲状腺炎的患者(4例pN1 [36.4%];7例pN0 [63.6%]),而无桥本甲状腺炎的患者为(34例pN1 [82.9%];7例pN0 [17.1%];p = 0.002)。
结论
甲状腺乳头状癌较高的发生率和多灶性可能是先前存在的桥本甲状腺炎的结果,可被视为支持癌变的肿瘤前刺激因素,尽管这种相关性的确切发病机制尚不清楚。《匈牙利医学周报》,2017年,158(5),178 - 182。