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目的 探讨和分析桥本病 (HD)并发甲状腺癌 (TC)发病情况及诊治经验。方法 对1976年 1月～ 1999年 4月 15 0例HD病人中同时并发TC的 15例予手术治疗 ,还作病理学检查。并对2种疾病的并发率、发病机理、诊断和治疗经验进行分析。结果 HD与TC并发率为 10 % (15 / 15 0 ) ,术前确诊率 46 .7%。对 15例TC病人随访 3个月～ 19年 ,均无TC复发 ,效果满意。结论 HD与TC可能有共同的发病机理 ,即免疫缺陷和内分泌功能失调。临床上应术前常规测血甲状腺球蛋白抗体、甲状腺微粒体抗体、细针穿刺细胞学检查及术中作冰冻切片 ,利于术前和术中确诊及正确选择手术方法。
Objective To investigate and analyze the incidence of Hashimoto’s disease (HD) complicated with thyroid cancer (TC) and its diagnosis and treatment. Methods Fifteen patients with concurrent HD with 15 HD patients from January 1976 to April 1999 underwent surgical treatment and pathological examination. The incidence, pathogenesis, diagnosis and treatment experience of the two diseases were analyzed. Results The complication rate of HD and TC was 10% (15/150). The preoperative diagnosis rate was 46.7%. 15 cases of TC patients were followed up for 3 months to 19 years, no TC recurrence, the effect is satisfactory. Conclusion HD and TC may have a common pathogenesis, namely, immunodeficiency and endocrine dysfunction. Clinical preoperative routine measurement of thyroglobulin antibody, thyroid microsomal antibodies, fine needle aspiration cytology and intraoperative frozen section, which will help preoperative and intraoperative diagnosis and the correct choice of surgical methods.