甲状腺乳头状癌合并2 型糖尿病的 临床病理特征分析

Analysis of clinicopathological features of papillary thyroid carcinoma with type 2 diabetes mellitus

摘要:

目的 探讨并分析甲状腺乳头状癌（PTC）合并2 型糖尿病（T2DM）患者的临床病理特征及 两者间的相关性。方法 选取2015 年9 月—2019 年12 月于西南医科大学附属医院甲状腺外科行甲状腺手术， 术后经病理确诊为PTC 的130 例患者。将65 例合并T2DM 的PTC 患者作为研究组，65 例未合并T2DM 的 PTC 患者作为对照组。分析两组患者甲状腺功能三项的差异，比较两组在肿瘤大小、多灶性（癌灶数目≥ 2 个）、 被膜侵袭、腺外侵袭、合并桥本甲状腺炎或良性甲状腺结节、颈部淋巴结转移等病理特征的差异。结果 研 究组空腹血糖较对照组高（P <0.05），游离三碘甲状腺原氨酸（FT3）较对照组低（P <0.05）。研究组多灶性、 被膜侵袭、腺外侵袭及颈侧区淋巴结转移例数较对照组多（P <0.05）。结论 合并T2DM 的PTC 患者具有 更低的FT3 水平，同时具有多灶性、更高的被膜和腺外侵袭率及颈侧区淋巴结转移率。

Abstract:

Objective To analyze the clinicopathological features of papillary thyroid carcinoma (PTC) with type 2 diabetes mellitus (T2DM) and their clinical relevance. Methods A total of 130 patients who underwent thyroidectomy and were confirmed with PTC by histopathologic examination in the Affiliated Hospital of Southwest Medical University from September 2015 to December 2019 were selected in the retrospective analysis, among which 65 PTC patients with T2DM were enrolled as the study group and 65 cases without T2DM were enrolled as the control group. Thyroid function, tumor size, multifocality ( ≥ 2), capsular invasion, extrathyroidal extension, comorbidity with benign thyroid nodules or Hashimoto’s thyroiditis, and cervical lymph node metastasis were compared between the two groups. Results Compared to the control group, the patients in the study group showed lower levels of free triiodothyronine (P < 0.05), and the lesions were more inclined to present multifocality, capsular invasion, extrathyroidal extension and lateral cervical lymph node metastasis (P < 0.05). Conclusions The PTC patient with T2DM shows lower level of free triiodothyronine, and the tumor seems more likely to be multifocal, with capsular invasion, extrathyroidal extension and lateral cervical lymph node metastasis, compared to PTC patient without T2DM.