慢性淋巴细胞性甲状腺炎合并甲状腺结节的临床分析

目的:研究分析中国东北地区慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺结节的诊断和治疗方式.方法:回顾性分析2009年9月--2010年12月收治经病理证实的CLT合并甲状腺结节的共151病例,依据不同的病理类型分组,就临床特点、诊断和治疗进行比较.结果:CLT合并甲状腺乳头状癌组共58例,女性51例,男性7例,平均年龄37.5±4岁,平均病程18个月,28例为腺体内单发结节,病灶平均直径为0.9± 0.56 cm,36例病灶直径小于1.0 cm,42例见结节内伴钙化.CLT合并良性结节组98例,女性患者93例,男性患者5例,平均年龄48.1±9岁,平均病程72个月,34例为腺体内单发结节,病灶平均直径1.8± 0.42 cm,35例病灶直径小于1.0 cm,10例见结节内伴钙化.两组在发病年龄、病程、结节个数及钙化方面的差异均有统计学意义.结论:CLT合并甲状腺癌微小癌多见,淋巴结转移率低,彩超提示单发结节或者结节合并钙化的病例,应行手术治疗.

Clinical Study of Coexistent Chronic Lymphocytic Thyrioditis with Nodules

Objective: To investigate the principles of diagnosis and treatment of the patients who has chronic lymphocytic thy-roiditis(CLT) coexistent with nodules in northeast area of China.Methods: We retrospectively analysed the 151 cases of CLT concomi-tant with nodules from September 2009 to December 2010.A comparison of the clinical data including clinicopathologic features,treat-mentand prognosis was made between these groups by retrospective research.Results: The patients of CLT coexistent papillary thyroid carcinoma included 51 women and 7 men,with an average age of 37.5±4 years and symptoms duration of 18 months,and there were 28 cases of solitary nodule.The mean tumor size was 0.9±0.56 cm,and 36 cases foci diameter <1.0 cm,and 42 cases of calcification.The patients with benign nodules included 93 women and 5 men,with average age of 48.1±9 years symptoms duration of 72 months,and 34 cases of solitary nodule.The mean tumor size was 1.8±0.42 cm,and 35 cases foci diameter <1.0 cm,and 10 cases of calcification.Age of onset,symptoms duration,nodule numbers and calcification in nodules had significant difference between these groups.Conclusion: The chronic lymphocytic thyroiditis coexist with thyroid carcinoma was mostly papillary thyroid microcarcinoma having a low rate lymph node metastasis.Surgical intervention should be considered with such conditions,including solitrary solid nodule and calcifi-cation revealed by ultrasonography.