| Objective:Combined postoperative pathologic results of thyroid nodules in patients with observation of Hashimoto’s thyroiditis’s proportion in benign and malignant of thyroid nodule and the clinicopathological features,and analyze the clinicopathological features of Hashimoto’s thyroiditis associated with thyroid nodule. To provide a theoretical basis for clinical diagnosis and treatment of Hashimoto’s thyroiditis associated with thyroid nodule.Methods:Collect522cases of thyroid nodule which need surgical therapy in Shan Dong province hospital from January2012to December2012and analyze the clinical data.110cases be diagnosed as nodular goiter and17cases are associated with Hashimoto’s thyroiditis(HT).412cases be diagnosed as thyroid carcinoma and106cases are associated with HT. Among thyroid carcinoma cases,401cases are pathologically diagnosed as papillary thyroid carcinoma (PTC),99cases are associated with Hashimoto’s thyroiditis. I adopted random sampling method to choose50cases from each group (sample of PTC and sample of PTC associated with HT). Do retrospective study on these two groups then analyze and compare in age, sexuality, tumor size, lymphatic metastasis, clinical stage by statistics method.Results:1. Of all the110cases of the nodular goiter patients, there are17cases (15.5%) are associated with Hashimoto’s thyroiditis. Of all the412cases of thyroid carcinoma patients, there are106cases (25.7%) are associated with Hashimoto’s thyroiditis. Of all the99cases of papillary thyroid carcinoma patients, there are99cases (24.5%) are associated with Hashimoto’s thyroiditis.2. Do case-control study on the sample of papillary thyroid carcinoma (group A) and the sample of papillary thyroid carcinoma associated with Hashimoto’s thyroiditis (group B),we can find that in group A the average age is44.1+9.4, the average tumor size is1.06+0.68cm, the average number of metastatic lymph node is2.06+0.38,clinic stage I is32cases(64.0%),clinic stage II is2cases(4.0%),clinic stage III is16cases(32.0%).The tumor size and the number of metastatic lymph node have notable correlation, correlation coefficient P=0.581,they is positive correlation between tumor size and lymphatic metastasis (P=0.0001<0.05),other data has no correlation. In group B the average age is43.5+11.8, the average tumor size is0.99+0.75cm, the average number of metastatic lymph node is2.40+0.15,clinic stage I is41cases(82.0%),clinic stage II is2cases(4.0%),clinic stage III is7cases(14.0%)(Staging standard refer to People’s Medical Publishing House, first edition of special materials for8years and7years of clinical medicine Surgery). In group B the tumor size is negative correlated with age, correlation coefficient P=-0.297((P=0.036<0.05),the tumor size is notable positive correlated with the number of metastatic lymph nod, correlation coefficient P=0.577(P=0.0001<0.05).3.①There is no significant difference in average age and no statistical difference in the distribution of the age(P=0.790>0.05).41-45years old is the age bracket up to13cases(26%) and20cases(40%) are over45-year in group A.31-35years old is the bracket up to10cases(26%) and21cases(42%) are over45-year in group B.②There is statistical difference in sexuality(P=0.046<0.05), the incidence of the PTC associated with HT among women is higher than it among men.③There is statistical difference in tumor size(P=0.004<0.05),the average tumor size in group B is lower than group A. In group B,32%has the tumor size concentrated in the range of0-0.5cm and it is20%in group A.8%is more than2.0cm in group B and it is10%in group B.④There is no statistical difference in the number of metastatic lymph node(P=0.669>0.05). In the distribution of the number of metastatic lymph node,38%with no lymph node metastasis in group A and it is54%in group B,14%of group A has metastatic lymph node number≥4and it is22%in group B.⑤These two groups have statistical difference in clinical staging (P=0.013<0.05) and clinic stages in group B is lower than group A.Conclusion:(1)The incidence of thyroid carcinoma associated with Hashimoto’s thyroiditis is higher than that of thyroid benign nodule associated with Hashimoto’s thyroiditis. We can say there must have some synergistic or promotion effects of Hashimoto’s thyroiditis to the occurrence of thyroid carcinoma and protective effects to the stage of development.(2)The number of metastatic lymph node increases with increasing age in group A, they have positive correlation, P=0.581((P=0.0001<0.05) and other data has no correlation. Tumor size decreases with increasing age in group B, they have negative correlation, P=-0.297((P=0.036<0.05) and tumor size is positive correlated with the number of the lymph node’metastasis, P=0.577(P=0.0001<0.05).(3)We can find there is no statistical differences in the age(P=0.790>0.05) and number of the lymphnode’s metastasis(P=0.669>0.05) and there are statistical differences in sex (P=0.046<0.05),tumor size (P=0.004<0.05) and clinic stage (P=0.013<0.05) by study comparing data from group A and group B,... |
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