Clinical and Ultrasonic Characteristics of Multiple Primary Tumors of Thyroid and Breast
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摘要:
目的 分析甲状腺及乳腺多原发癌的临床和超声特征。 方法 回顾性分析1990年1月至2013年3月在北京协和医院接受诊治且手术病理证实的甲状腺及乳腺多原发癌24例, 比较这些患者的甲状腺癌及乳腺癌临床和超声特征。 结果 24例患者中9例(37.5%)以甲状腺癌首发, 其中2例(22.2%)在1年内出现乳腺癌; 15例(62.5%)以乳腺癌首发, 其中6例(40.0%)在1年内出现甲状腺癌。甲状腺癌和乳腺癌超声表现均多为实性(86.4%和84.2%)、形态不规则(63.6%和94.7%)、纵横比大于1(50.0%和57.9%)、边界不清(63.6%和78.9%)、低回声或极低回声(90.9%和100%)、点状钙化(50.0%和47.4%)、局部丰富血流(50.0%和68.4%)。 结论 甲状腺及乳腺多原发癌的临床和超声特征与单发甲状腺癌及乳腺癌人群相近, 超声可有效地筛查甲状腺及乳腺多原发癌, 尤其在首发乳腺癌后1年内。 Abstract:Objective To summarize the clinical and ultrasonic features of multiple primary thyroid and breast cancers. Methods The clinical and ultrasonic features of 24 patients with pathologically confirmed multiple primary thyroid and breast cancers who were treated in our hospital between January 1990 and March 2013 were retrospectively analyzed and compared. Results All patients were women. For 9 patients (37.5%) with breast carcinoma after thyroid carcinoma, the intervals between these two diagnoses were less than 12 months in 2 patients (22.2%).For 15 patients (62.5%) with thyroid carcinoma after breast carcinoma, the intervals between these two diagnoses were less than 12 months in 6 patients (40.0%). Most of thyroid carcinomas and breast carcinomas were presented as solid mass (86.4% and 84.2%), rregular shape (63.6% and 94.7%), aspect ratio > 1 (50.0% and 57.9%), indistinct margin (63.6% and 78.9%), hypoechoic appearance (90.9% and 100%), punctuate calcification (50.0% and 47.4%), and focal extensive blood flow (50.0% and 68.4%). Conclusions The clinical and ultrasonic features of multiple primary thyroid and breast cancers are similar to those of patients with thyroid carcinoma or breast carcinoma. The ultrasonography can effectivelydetect this condition, especially within the first year after the diagnosis of breast carcinoma. -
Key words:
- thyroid carcinoma /
- breast carcinoma /
- multiple primary tumors /
- ultrasonography
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表 1 甲状腺及乳腺多原发癌患者诊断时年龄
特征 n 诊断时年龄(岁) 间隔(月) 甲状腺癌 乳腺癌 x±s 范围 x±s 范围 x±s 范围 甲状腺癌首发 9 45.0±14.1 26~72 50.2±13.1 30~72 65.4±53.3 0~168 乳腺癌首发 15 53.9±7.1 41~68 49.3±8.5 36~67 54.4±62.3 2~171 表 2 甲状腺及乳腺多原发癌病理特征
甲状腺癌 合并乳腺癌 病理特征 例(%) 病理特征 例(%) 乳头状癌 22(91.7) 导管内癌 1(4.2) 早期浸润性导管癌 3(12.5) 浸润性导管癌 16(66.7) 粘液癌 1(4.2) 髓样癌 1(4.2) 滤泡癌 1(4.2) 浸润性导管癌 1(4.2) 髓样癌 1(4.2) 浸润性导管癌 1(4.2) 表 3 甲状腺及乳腺多原发癌临床特征
肿瘤类型 n 多灶癌
[例(%)]合并症
[例(%)]肿瘤大小
(cm)位置[例(%)] 左侧 右侧 两侧 甲状腺癌 22 4(18.2) 15(68.2) 1.1±0.8 8(36.4) 13(59.1) 1(4.5) 乳腺癌 24 2(8.3) 9(37.5) 2.1±0.9 13(54.2) 11(45.8) 0 表 4 甲状腺及乳腺多原发癌的超声特征[例(%)]
肿瘤类型 n 实性 形态不规则 纵横比大于1 边界不清 低回声或极低回声 点状钙化 局部丰富血流 转移 甲状腺癌 22 19(86.4) 14(63.6) 11(50.0) 14(63.6) 20(90.9) 11(50.0) 11(50.0) 3(13.6) 乳腺癌 19 16(84.2) 18(94.7) 11(57.9) 15(78.9) 19(100) 9(47.4) 13(68.4) 6(31.6) -
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