갑상선암 동반 가능성을 고려한 하시모토 갑상선염의 수술 적응증

• 영문명: Operative Indications for Hashimoto's Thyroiditis in Consideration of the Risk of Concurrent Thyroid Carcinoma
• 발행기관: 대한내분비외과학회
• 저자명: 최성림 유봉옥 김인수¹ 김윤규¹ Sung Lim Choi M.D. Bong Ok Yoo M.D. In Soo Kim M.D.¹ and Yoon Kyoo Kim M.D.¹
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』2권1호, 10~14쪽, 전체 5쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2002.06.30

영문 초록

Purpose: This study was performed to further refine the indications for operative treatment of patients with Hashimoto's thyroiditis, and also to present the better histopathologic diagnosis method for Hashimoto's thyroiditis. Methods: The authors evaluated retrospectively 130 patients with surgically proven Hashimoto's thyroiditis at presbyterian medical center in Chonju and Yonsei hospital in Masan from Jan. 1995 to Feb. 2002. Results: The sensitivity of gun biopsy for the diagnosis of Hashimoto's thyroiditis was significantly higher than the one of fine needle aspiration (83.3% vs 46..2%, P＜0.001). There were 26 cases (13.8%) of coexistent carcinoma of 130 patients. The incidence of carcinoma in men (6 in 9, 66.6%) was significantly higher than in women (20 in 121, 16.5%, P＜0.05). The incidence of carcinoma in antithyroglobulin antibody negative group (8 in 10, 80%) was significantly higher than in antibody positive guoup (16 in 111, 14.4%, P＜0.001). There was no significant difference in the incidence of carcinoma between positive and negative lymphadenopathy groups (22.6% vs 20.0%, P=0.681). As for ultrasonographic findings, patients with irregular-marginated dominant nodule or calcification had significantly higher incidence of carcinoma than those without so findings had (P＜0.001). As for the distribution patterns of lymphocytes infiltration, the incidence of carcinoma in nodular or localized pattern groups is significantly higher than in diffuse group (24.5% vs 8.3%, P＜0.05). Conclusion: For histopathologic diagnosis of Hashimoto's thyroiditis, gun biopsy is more sensitive than fine needle aspiration. And the incidence of concurrent carcinoma in patients with Hashimoto's thyroiditis is increased under the circumstances as follows: men, negative antithyroglobulin antibody results on serologic test, ultrasonographic findings such as irregular-marginated dominant nodule, increased vascularity or calcification, and nodular or localized patterns of lymphocytes infiltration on histopathologic examination. (Korean J Endocrine Surg 2002;2:10-14)

키워드

하시모토 갑상선염, 갑상선 암종, 수술 적응증,Hashimoto's thyroiditis, Thyroid carcinoma, Operative indications