31 Clinical Research Of Thyroid Carcinoma Conbine With Hashimoto's Clincal Analyze

Objective:To analysis and discuss the thyroid carcinoma with Hashimoto's thyroiditis about the clinical characteristic of the disease,And to explore the Preoperative diagnosis about thyroid carcinoma with Hashimoto's thyroiditis.Through the comparison of simple thyroid carcinoma and thyroid carcinoma patients with Hashimoto's thyroiditis cases in age,gender,symptoms,ultrasound examination,thyroid function tests,thyroid antibody examination,intraoperative and postoperative pathological results.Methods:This study used a way of retrospective analysis to review about 163 cases from January 2013 to January 2017 in Affiliated Hospital of Taishan Medical University,those are diagnosed by rapid intraoperative pathology or postoperative routine pathology.There are about 31 cases associated with Hashimoto's thyroiditis.According to the classification of simple thyroid carcinoma and Hashimoto's thyroiditis,163 cases were divided into simple thyroid carcinoma group(n=132)and thyroid carcinoma combined with Hashimoto's thyroiditis group(n=31).To compare the differences in age,sex,symptoms and signs,preoperative ultrasonography,preoperative TSH and T3T4 levels,preoperative thyroid antibody levels and lymph node metastasis.Results:The average age of the thyroid cancer combined with Hashimoto's thyroiditis(A group)which have 31 cases is 43.55 + 11.29 years;among these cases,there are 4 males and 27 females,18 cases of thyroid tumor,9 cases of goiter,4 cases of neck compression or pain;There are 20 cases which are found of thyroid nodules than 1cm by preoperative ultrasonography,6 cases of nodule size between 1-4cm,5 cases of nodule which size are larger than 4cm;preoperative thyroid function examination found 28 cases with normal T3T4,T3T4 increased in 3 cases.The average age of Simple thyroid carcinoma group(B group)which have 132 cases is 49.40 + 12.83 years old;among these cases,there are 43 male cases and 89 female cases,84 cases of goiter,thyroid enlargement in 36 cases,12 cases of neck compression or pain;There are 79 cases which are found of thyroid nodules than 1cm though preoperative ultrasonography,38 cases of nodular size ranged from 1-4cm in 15 cases,38 cases of nodule size larger than 4cm;preoperative thyroid function examination found 125 cases with normal T3T4,7 cases with elevated TSH.After statistical analysis of the above results,there was no significant difference between the two groups(P>0.05).There are 24 cases with normal TSH among the group of thyroid cancer combined with Hashimoto's thyroiditis(A group)which have 31 cases,1 cases of TSH increased,TSH decreased in 6 cases;preoperative thyroid function examination showed 12 cases of thyroid antibodies in normal,thyroid antibodies increased in 19 cases;There are 26 cases which have not the lymph node metastasis though routine pathological examination,while 5 cases with lymph node metastasis.There are 130 cases with normal TSH,TSH increased in 0 cases;2 cases of TSH decreased in Simple thyroid carcinoma group(B group)which have 132 cases;preoperative thyroid function examination showed 121 cases have normal TSH and 11 cases have high level of TSH.the routine postoperative pathological examination found no lymph metastasis in 82 cases,while 50 cases with lymph node metastasis.After statistical analysis of the above results,the difference between the two groups was statistically significant(P>0.05).Conclusion:To compared with simple thyroid cancer,thyroid cancer combined with Hashimoto's thyroiditis have some differences in age,gender,clinical presentation,preoperative T3T4 and the nodule indicated in preoperative color Doppler,but after statistical analysis found that the difference was not statistically significant.There were significant differences in preoperative TSH,thyroid antibody and postoperative lymph node metastasis.Obviously,thyroid cancer associated with Hashimoto's thyroiditis can be identified from simple thyroid cancer though the level of preoperative TSH and thyroid antibodies,besides thyroid cance patients with Hashimoto's thyroiditis can reduce lymph node metastasis.