原发性甲状腺鳞状细胞癌的临床特征与诊治附7例报告.docVIP

原发性甲状腺鳞状细胞癌的临床特征与诊治:附7例报告 范向达 武元元 王军 张建伟 马亚兵 李波 甘肃省肿瘤医院头颈外科 甘肃省肿瘤医院超声科 甘肃省肿瘤医院病理科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的:探讨原发性甲状腺鳞状细胞癌 (SCCT) 的临床、超声及病理特征以及治疗和预后。方法:回顾性分析2010年1月—2015年12月收治的7例原发性SCCT患者的临床表现、超声声像图特征、术后病理结果和综合治疗效果。结果:7例原发性SCCT占同期全部甲状腺癌的0.96% (7/728) , 其中男3例, 女4例, 平均年龄62.7岁。所有患者均可触及颈部肿块, 4例伴呼吸困难, 2例伴声音嘶哑, 1例伴吞咽困难。病灶超声声像图均表现为形态不规则的实性混合性回声光团, 5例肿块侵透甲状腺被膜, 2例伴有微钙化, 4例有异常颈部淋巴结。手术治疗5例 (甲状腺癌联合根治术2例, 局部广泛切除术2例, 姑息性切除术并同时行预防性气管切开1例) , 2例仅行粗针穿刺活检。患者病理均证实为SCCT, 3例合并结节性甲状腺肿, 2例合并甲状腺乳头状癌, 7例肿瘤细胞P63免疫组化均阳性。5例手术患者术中, 4例术后行放疗或放疗+化疗, 1例未行综合治疗;2例粗针穿刺活检患者行单纯放疗或放疗+化疗。仅1例行根治性切除术联合术后放疗的患者生存期超过1年, 其余均在半年内死亡。结论:原发性SCCT恶性程度高, 病情发展迅速, 预后差。其临床表现及超声声像图具有一定的特征性, 有助于术前诊断, 免疫组化对鉴别诊断非常重要, 积极的综合治疗可能改善患者预后。 关键词： 甲状腺肿瘤/治疗; 肿瘤, 鳞状细胞; 预后; 作者简介：范向达, 甘肃省肿瘤医院副主任医师, 主要从事甲状腺肿瘤诊断及治疗方面的研究。 作者简介：武元元, Email:584276794@ 收稿日期：2017-01-15 基金：甘肃省卫生行业科研计划基金资助项目 (GWGL201488) Clinical features, diagnosis and treatment of primary squamous cell carcinoma of thyroid:a report of 7 cases FAN Xiangda WU Yuanyuan WANG Jun ZHANG Jianwei MA Yabing LI Bo Department of Head and Neck Surgery , Gansu Provincial Cancer Hospital; Department of Ultrasound Diagnostics , Gansu Provincial Cancer Hospital; Department of Pathology, Gansu Provincial Cancer Hospital; Abstract： Objective: To investigate the clinical, ultrasonic and pathologic characteristic as well as treatment and outcomes of primary squamous cell carcinoma of thyroid (SCCT) .Methods: The clinical presentations, ultrasonic features, pathologic findings and results of comprehensive treatment of 7 primary SCCT patients admitted from January 2010 to December 2015 were retrospectively analyzed.Results: The 7 primary SCCT patients accounted for 0.96% (7/728) of the total number of thyroid cancerpatients admitted during the same period, of whom, 3 cases were male and 4 cases were female, with an average age of 62.7 years. All patients had palpable neck mass that was associated with dyspnea in 4 cases, hoarseness