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目的:探讨结节性甲状腺肿并存甲状腺癌的临床特点及治疗方法。方法:回顾性分析2005年1月至2010年6月深圳市西乡人民医院和中山大学附属第一医院手术治疗并经病理证实的39例结节性甲状腺肿并存甲状腺癌患者的临床资料。结果:本组患者共39例,占同期甲状腺癌患者的35.1%,发病年龄14～78岁,平均年龄(44.2±14.1)岁,男女比例为1:2.9。肿块直径<2.0 cm者占64.1%,Ⅰ期20例、Ⅱ期9例、Ⅲ期4例、Ⅳ期6例。病理类型以乳头状癌为主(71.8%)。结论:结节性甲状腺肿并存甲状腺癌的癌灶较小,乳头状癌占绝大多数;术前超声和术中冰冻切片快速病理检查是提高并存甲状腺癌检出率的关键;定期随访有利于提高结节性甲状腺肿并存甲状腺癌患者的早期诊断率。
Objective: To investigate the clinical characteristics and treatment of nodular goiter complicated with thyroid cancer. Methods: The clinical data of 39 patients with thyroid nodular goiter complicated with thyroid cancer underwent surgical treatment and pathologically confirmed by Xixiang People’s Hospital of Shenzhen and First Affiliated Hospital of Sun Yat-sen University from January 2005 to June 2010 were retrospectively analyzed. Results: A total of 39 patients in this group accounted for 35.1% of thyroid cancer patients in the same period. The age of onset was from 14 to 78 years. The average age was (44.2 ± 14.1) years. The male to female ratio was 1: 2.9. The tumor diameter was less than 2.0 cm, accounting for 64.1%. There were 20 cases in stage Ⅰ, 9 cases in stage Ⅱ, 4 cases in stage Ⅲ and 6 cases in stage Ⅳ. Papillary carcinoma was the main pathological type (71.8%). Conclusions: Nodular goiter complicated with thyroid cancer is smaller and papillary carcinoma is the most common. Preoperative ultrasonography and intraoperative frozen section rapid pathological examination are the key to improve the detection rate of concurrent thyroid cancer. Regular follow-up is helpful Improve the early diagnosis rate of nodular goiter coexisting thyroid cancer.