Y HOC VIET NAM THANG 5 • SO 2/2015
(1999).Ultrasonography for diagnosis of acute?
appendicitis: results of a prospective multicenter trial. Acute Abdominal Pain Study Group.World J Surg.; 23(2), pp. 141-146.
Wilson D, Sinclair S et al (1994). Acute appendicitis in young children in the Belfast urban area: 1985-1992. Ulster Med J, 63, pp. 3-7.
Rambha Rai, Chan-Hon Chui, Sai Prasad TR
(2007). Perforated Appendicitis m Children:
Benefits of Early Laparoscopic Surgery. Am. Surg, 36, pp. 277-280.
Wojciech Korlaciti, 3o zef Dzieiicki (2008).
LapanDSCopic Appendectomy for Simple and Complicated Appendicitis in Children-Safe or Risky Procedure. Surg Laparosc Endosc Percutan Tecli, 18(1), pp. 29-32.
YEU TO ANH HiraNG DEN THai GIAN SONG THEM COA BENH NHAN UNG THU- VU CO THU THE NOI TIET AM TI'NH
T6M TAT
Myc tiSu; Oanh gia mpt so yeu td anh hu'dng den thdi gian song them ciia benh nhan ung thu' vu cd thu t h i ndi tiet am tfnh.
Phu'dng phdp: Nghien cifu hdi culi trgnl41 benh nhan ung thu' vii thu the noi t i ^ am tinh, giai doan I I - III dieu trj triet c3n, theo doi thdi gian song them sau dieu tri.
Ket q u i : Thdi gian sdng them toan bd va sdng ttiem khong tai phat sau 5 nSm tu'dng irtig la 75,2%;
68%. Mpt so y^u to anh hu'dng den thdi gian sdng ttiem sau dieu tri. Tinh trang di c3n hach va sd lu'dng hach di cSn nach anh hirdng nhieu nhift. So lu'dng hach nach di cSn anh hu'dng ldn den thdi gian sdng cua benh nhan, tticfi gian song them ty le^nghjch vdi so luVng hach nach di c3n, khong di can hach nach cao hdn neu dl c§n >, 4 hach nach, 90,6% so vdi 39,3%. Hda chat bo tn? sau md gdp phan cai thien thdi gian song th6m nhdm benh nhan thu the am tinh, Ket lu$n: Thdi gian sdng them sau dieu tri phu thudc ca cac yeu td tien lu'dng benh va lieu phap dieu trj bo trd toan than
TWkhda: ung thu' vii, thu the am tinh, thdi gian song them
S U M M A R Y
THE FACTORS EFFECTING THE SURVIVAL OF BREAST CANCER PATIENTS W I T H
NEGATIVE HORMONE RECEPTORS Objective: Evaluate the clinical and prognostic factors affecting the survival of breast cancer patients with hormone receptor-negative
* Bp mon Ung thd, Trudng Dai hpc Y Ha Npi Chju trach nhi?m chinh: Vu Hong Thang Email: [email protected] Dt: 0913394487 Ngay giii bai: 5/3/2015
Ngay phan bi?n khoa hoc: 16/3/2015 Ngay duyet bai: 26/3/2015
Vfl Hong Thang*
Methods: Retrospective study on 141 breast cancer patients with hormone receptor -negative, stage I I - I I I , radical treatment, follow-up for the long- term survival. .,
Results: Overall survival and disease-free sun/ival after 5 years was 75.2%, 68%, respectively. A number of factors affect survival after treatment.
Status of lymph node metastasis and the number of axillary lymph node metastases most affected: The number of axillary lymph node metastases significantly Impact on survival. The overall survival is inversely proportional to the number of axillary lymph node metastases. No axillary lymph node metastasis 90.6%
of survival that was more farvoral as compared to patients with 4 axillary lymph nodes metastases 39.3%. Adjuvant chemotherapy had a role to improve survival of this patient group.
Conclusion: Survival after treatment depends on both prognostic factors and complementary therapies Keywords: Breast cancer, negative receptor, breast cancer survival
I.OATVXNDE
Ung t h u bieu m d (UTBM) tuyen vCi rat phiit tap. Mpt so yeu to tien lu'dng ung thu* vii da du'dc xac djnh nhd giai doan benh, do mo hoc, loai md hoc, tinh trang t h u the noi tiet, tinh trang boc Id yeu t d tang tru'dng bieu m d [ 1 ] . De danh gia thu the noi tiet (TTNT) Estrogen Receptor (ER) va Progesterone Receptor (PR) ddi vdi ung thd v u , xet nghiem hda m d mien djch (HMMD) hoac xet nghiem sinh hpc phan tiT danh gia khuech dai gen HER2. Nghien eifu ta! benh vifin K cho thay 3 6 , 7 % tru'dng hdp ung tliu' vu khdng cd thy the noi tiet, nghTa la ER(-), PR(-). Oieu tri ung thu" vu can s y ghdi hdp giO'a phu'dng phap tai cho, tai vimg (phau thuat - PT, xa tri - )Cr) va toan than (hda chat, npi tiet, lieu phap sinh hpc).
56
Y HOC VIET NAM THANG 5 - SO 2/2015
Hien nay, nhd tien bd trong sang Ipe phat hien sdm va dieu trj nen hieu qua dieu tri ngay eang cao [1], [2]. Thu the ndi tiet ed y nghTa tien lu'dng benh va cd gia tri trong dieu tn. Ung thd vu cd TTNT du'dng tfnh dap img tdt vdi dieu tri ndi tiet, cdn ung thd vu cd TTNT am tinh cd tien lu'dng xau do ban che ve li/a chon dieu trj, va cd xu hu'dng di can vao eac tang sau. Mdt nghien cifu thir nghiem lam sang cho thay hieu qua ciia dieu tn ndi tiet eung nhu" ket qua dieu tri eiia ung thd vu cd TTNT du'dng tinh [3]. Tuy nhien, tru'dng hdp ung thd vu TTNT am tinh cd tinh dac truYig lam sang va ket qua dieu tri ciia the benh nay den nay chu^ du'dc lam sang td. Do vay, de tai nay du'dc thu'c hien vdi muc tieu: Dinh gii mpt so yeu td inh hwdng den thdi gian sdng thim cda benh nhin ung thW vu co thu thi'n^i tiet im tinh.
II. DOI UrpMG vA PHU'OIMG PHAP NGHIEN ClXi 2.1. Doi tu'dng nghien cijfu
Benh nhan nd ung thu* vu, thu the ndi tiet am ti'nh, giai doan II - IIIA da du'dc dieu tn triet de tai Benh vien K tir" nam 2003 - 2009.
2.2. Phu'dng phap nghien cili'u
* Thiet ke nghien cWu: Phu'dng phap nghien cifu hdi cifu md ta. Cd mau tdi thieu tfnh du'dc tiieo cdng thil'c eua To chii'c Y te the gidi la 103 benh nhan. Thu'c te, nghien ciTu da tien hanh du'dc tren 141 benh nhan ung thu* vu, thu the ndi tiet am tfnh, giai doan II - IIIA da du'dc dieu trj triet de tai Benh vien K tii" nam 2003 - 2009 cd dil cac thdng tin theo doi trong va sau dieu trj.
* PhWdng phip thu th$p sd li^u: Thu thap s5 lieu thong tin benh nhan theo mau benh an nghien ciili thdng nh§ft.
- C&" didng dn ve lim sang va mo benh hgc + Cac benh nhan dutfc khai thac thu thap thdng tin chung ve ban thSn nhd tudi, benh kem theo, ngay vao vien, ngay md, ngay ra vien, ly Bing 1. Phan bd benh nhan theo md benh hpc
do^den vien, thdi gian bi benh, giai doan, the giai phau benh va sd lu'dng hach nach di can.
+ Ky thuat hda md mien dich: dLTdc thu'c hien tren md due khdi nen vdi cac dau an miln djch ER, PR, HER2 tren tieu ban benh pham sau md. Danh gia ket qua theo tieu chuan ciia Aired du'a vao ty ie va cu'dng dp bat mau eiia te bao u.
-I- Cac phu'dng phap dieu trj: Oieu tn triet can, phau thuat cat toan bd tuyen vii ket hdp vet hach nach, dieu tn hda chat, xa trj bo trd. S^
dung 3 phac do dieu trj: phau thuat -i- hda chat + xa tri, phau thuat -i- xa trj, phau thuat + hda chcit theo hu'dng dan thi/c hanh ehan doan va dieu trj tai benh vien K.
- Theo ddi sau dieu trj danh gia sdng them De danh gia thdi gian song them toan bp (STTB) va thdi gian sdng them khdng tai phat, di can (STKTP/DC) bang theo doi sau khi ra vien qua kham lai djnh ky 3 thang/lan trong hai nam dau, 6 thang/lan trong 3 nam tiep theo. Td nam thif 5 trd di se tai kham 1 nam/lan. Benh nhan se du'dc kham lam sang phat hien dau hieu tai phat tai cho tai vimg, tai phat cd quan xa.
2.3. XWiysdIleu: Sd lieu nghien cu'u du'dc nhap, xif ly va phan tfch tren may tinh, sir' dung phan mem SPSS 21.0; Sd dung thuat toan khi binh phu'dng so sanh ty le giij^ hai nlidm vdi dp tin cay 95%, lay y nghTa tiidng ke mii'c 5%.
III. KET QUA
__ Tuoi trung binh ciia benh nhan la 50,2 ± 8,5, tudi thap nhat la 27, cao nhat la 70. Nhdm tuoi 51-60 chiem ty le cao nhat la 44%; tiep den la nhdm tudi 41-513 (33,3%) va nhdm tudi <40 (13,5%). Nhdm tuoi >50 chiem ty |e thap nhat (9,3%). Ty le benh nhan dieu trj bang phae dd phau thuat + hda chat -i- xa trj cliiem ty le 44%, cd 31,2% dieu tri theo phac dd phau thuat + xa trj va 24,8% dieu trj theo phac do phau thuat + hda chat.
Loai mo benh hoc UTBM ong xam nhap UTBM the tiet dich
UTBM the tiiy UTBM tieu thiiy xam nhap
UTBM dang sang UTBM the di sgn UTBM te bao vay
So benh nhan
141
Ty le %
1,4 2,9
0,71,4
I ong so . . I i*ti I IUU | 100
Nh$n xit: ung thu" bieu mo the ong xam nhap la the hay gap nhat, chiem 91,4%, cac the giai phau benh khac hiem gap.
Y HOC VIET NARft THANG 5 - SO 2/2015
* Thdi gian song them chung ..-^ r mo m i Thdi gian theo ddi trung vj la 76 thang, benh nhan co thdi gian theo doi dai nhat la luo tnang, ngan nhat la 10 thang.
Bleu do 1: Thdi gian sdng khdng tai phat/di can va thdi gian sdng them toan bp
Nh$n xet:lh<S\ gian sdng them trung binh khdng tai phat/di can cua benh nhan (BN) trong nghien ciru la 80,4 ± 3,3 thang. Thdi gian sdng them toan bd trung binh la 86,0 ± 2,8 thang.
* Lien quan glu'a thdi gian song them vdi yeu to lam sang khac
Bii'u dd 2.a: Lien quan giii'a thdi gian Bii'u do 2.b: Lien quan glu'a thdi gian STKTP/ DC vdi tudi ^ STTB vdi tudi
Nhin xit: Doi vdi nhdm < 50 tuoi: Thdi gian sdng them toan bp trung binh la 88,1 thang, sau 5 nam ty le sdng khdng tai phaVdi can la 71,1%, ty le song chung la 75,7%. Ddi vdi nhdm > 50 tuoi;
Thdi gian song them toan bp trung binh la 84,4 thang, sau 5 nam ty le sdng khdng tai phaVdi can la' 65,3%, ty le sdng ehung la 73,3%. Su" khae biet ve thdi gian sdng them 2 nhdm khdng cd y nghia thdng kd (p > 0,05).
Bii'u dd 3.a. Lien quan giu^a thdi gian Bii'u do 3.b. Lien quan glu'a thdi gian STTB STKTP/DC vdi giai doan lam sang vdi giai doan lam sang
Nh$n xet: Sau 5 nam, ty le khdng tai phaVdi can ciia nhdm BN giai doan IIA la 77,3%, nhdm giai doan IIB la 67,1% va nhdm giai doan IIIA ia 58,3%. Trong 3 nhdm, nhom giai doan IIA cd ty le tai phat/di can thap nhat. Sd khac biet khdng cd y nghTa thdng ke (p=0,311j, Sau 5 nam, ty le sdngcOa nhdm BN glal doan IIA la 84,1%, ciia nhdm giai doan IIB la 72%, cua nhdm giai doan IIIA \h 66 7%.
Y HOC VI|T HAU THANG 5 - SO 2/2015
Bleu do 4.a: Lien quan glu'a thdi gian STKTP/DC vdi tinh trang di can hach
Nh$n xet: Sau 5 nam, t / le khdng til pha^di can ciia nhdm BN khdng di can hach nach la 87,5%, ciia nhdm di can 1-3 hach nach la 67,1%, ciia nhdm di c3n > 4 hach nach la 25%. Trong 3 nhdm, nhdm di can > 4 hach nach cd ty le tii phat/di can cao nhat, sir khae biet ed y nghTa
Bleu do 4.b: Lien quan g\da, thdi gian STTB vdi tinh trang di can hach
(p<0,001). Sau 5 nam, ty- le sdng ciia nhdm BN Ididng di can hach nach la 90,6%, cua nhdm di can 1-3 hach nach la 73,4%, ciia nhdm di can > 4 hach nach la 39,3%. Trong 3 nhdm, nhdm di can
> 4 hach nach cd ty le tif vong cao nhat, SLT khae biet cd y nghia thdng ke (p<0,001).
.^J
Bli'u d6 S.a: Lien quan giu^ thdi gian Bleu ^ S.b. Lien quan giu^ thdi gian STKTP/DC vdi phu'dng phap dieu tri STTB vdi phu'dng phap dieu trj
Nh$nxet:Sa\i 5 nam, ty Ie khdng tai phat/di can cua nhdm BN du'dc dieu tri bo trd sau mo bang XT la 67,8%, bang HC la 85,7%, bang HC va XT la 58,1%, sir khac biet nay ed y nghTa thdng ke (p<0,05). Sau 5 nam, ty le sdng chung ciia nhdm BN du'dc dieu trj bd trd sau md bang XT la 77%, bSng HC la 85,7%, bang HC va XT la 66,1%, SLT khac biet nay khdng ed y nghTa thdng ke (p>0,05)
Bii'u dd 6.a! Lien quan giiJa thdi gian Bii'u do S.b: Lien quan giiJa thdi gian TTB STKTP/DC vdi dieu trj hda chat vdi dieu tri hda chat
Y HOC VIET NAM THANG 5 - SO 2/2015
Nhin xet: Sau 5 nam, ty le song them khong tai phat/di can cua nhom BN khong dieu trj hoa chat bo trd la 67,8%, cua nhom co dieu trl hoa chat bo trd la 68% (p>0,05). Sau 5 nam, ty le song toan bp cua nhom khong dieu tri hoa chat bo trd la 77%, ciia nhom dieu tn co hoa chat la 73% (p>0,05).
IV. BAN LUAN
Ty le song them toan bo la 74,4%, ty le song them khong tai phat/di can la 68%. Cac tn/dng hdp tai phat/ di can xay ra 6 trong 3 nam dau, cao nhat la nam thCT 2 sau phau thuat (11,8%).
Trong nam thiJ 5, chi chiem 2,9%, trong nam thLT 6 khong co them tru'dng hdp nao. Cac tru'dng hdp tCr vong xay ra xay ra nhieu nhat trong nani thiJ 3 (9,9%). Theo Parise, doi vdi BN TTNT am tinh, sau 5 nam, ty ie song them toan bo la 79%, song them khong tai phat/di can ia 70,8% [4], ket qua nay phu hdp vdi nghien cu'u ciia Chung toi. T'/ ie nay thap hdn so vdi nghien cull ciia chiing toi, do Bardou chi thong ke nhu'ng BN khong du'dc dieu trj hda chat bo trd sau mo. Theo Parise, sau 5 nam, ty ie song them toan bp ciia nhom BN TTNT am tinh la 76% [4].
Tac giei Tran Van Thuan [3], nghien cii'u tren BN giai doan II-III cd TTNT du'dng tinh, sau 4 nSm ty le song them khong tai phat/di can la 75,5%, cao hdn nghien cifu ciia chung toi. Bleu nay khang djnh TTNT la yeu to Hen lu'dng. Ket qua tren cung phan nao chi ra du'dc tien lu'dng xau CLia UTV cd TTNT am ti'nh vdi cac tru'dng hdp cd TTI^T du'dng tinh. Khi da di can hach nach chuTig to benh da vu'dt ra khdi pham vi tai cho, tai viing. So lu'dng hach viing di can cang nhieu, tiii tien lu'dng cua benh cang xau [2]. Sau 5 nam, ty le khong tai phat/di can ciia nhdm BN khong di can hach nach la 87,5%, ciia nhdm di can 1-3 hach liach la 67,1%, cua nhdm di can > 4 hach nkh ia 25%. Trong 3 nhdm, nhdm di can > 4 hach nach cd ty ie tai phat/di can cao nhat, sU kiiac biet nay co y nghia thong ke (p<0,001).
Trong nghien ciru nay, sau 5 nam, ty le song cCia nhdm BN khong di can hach nach ia 90,6%, nhom di c5n >4 hach nach cd ty ie tir vong cao nhat. Tlieo tac gia Ta Van Td, BN khong di can hach ty ie song 5 nam ia 91,96%, di can 1-3 hach ia 60,59%, di can > 3 hach ia 43,25%.
Bleu ro rang rSng neu khong cd di can hach thi khong cd sU khac biet ve ket qua dieu trj, cho dii tac gia T? VSn Td nghien ciiu ve ung thu vii cd ca nhu'ng trUdng hdp tien IUdng tot hdn ve yeu to sinh hoc.
Sau 5 n5m, ty ie khong tai phat/di can ciia nhdm BN dUdc dieu trj bo trd sau mo bang XT la 67,8%, HC cao nhat ia 85,7%, HC va XT thap nhat ia 58,1%, sU khac biet nay cd y nghTa thong ke {p<0,05). Ty ie song toan bp ciia nhdm BN dUdc dieu tri bo trd sau mo bang XT ia 77%,
bang HC la 85,7%, bang HC va XT la 66,1%. Vai trd ciia dieu tri hda chat Anthracydine doi^vdi UTV cd TTNT am tinh, nhom dUdc dieu trl bo trS bang HC va XT cd ty ie thap nhat do nhCfng tru'dng hdp dd cd kich thu'dc u > 5cm va/ hoac da di can hach nach (83,9% cac tru'dng hdp dieu tri bo trd bang PT va XT cd dl can hach sau mo) nen ket qua dieu trj kem hdn cd the giai thich dUdc. Ket qua cua ciiung tdi tUdng tu" vdi nghien cuti cii'u tren 5427 benh nhan UTV khong dUdc dieu trj bo trd bang hda chat, trong nhdm oi TTNT am tinh, sau 5 nam, ty ie song them khong tai phat phat/di can la 67,7% [5]. Thdi gian song them toan bo trung binh ciia nhdm khong dieu trj hda chat 88,4 ± 4,5 thang cao hdn ciia nhdm dieu trl hda chat la 84,8 ± 3,6 thang. Sau 5 nam, ty le song them toan IDO ciia nhdm khdng dieu tri hda chat bd trd la 77%, cua nhdm dieu trj c6 hda chat la 73%. Bleu nay cd the glal thich nhi/
sau: Trong nghien ciru ciia chung toi, nhdm BN khong dieu tn hda chat bo trd du'dc chan doan d glal doan sdm hdn (34,1% BN chu'a cd di can hach nacii), Nhdm BN dieu trj bd trc( cd hda chat dUdc chan doan d giai doan mudn hdn (64% BN cd di can hach nach), tuy nhien ket qua dieu trj ciia 2 nhdm khong khac biet, tham chi ty ie song khdng tai phat/ di can ciia hai nhdm ia nhii' nhau (nhdm khdng dieu trj hda chat: 67,8% so v6i nhdm cd dieu tri hda chat: 68%). Trong nghien din nay, 68% BN dieu trj hda chat cd HER2 am tinh nen vai trd ciia hda chat vdi nhdm BN nay trong nghien diu chuS dUdc the hien ro. Tuy nhien, khong nen phii dinh vai trd ciia dieu trj hda chat cd Anthracydine doi vdi UTV cd TTTfT am tinh lien quan vdi HER2 [6], [7].
V. KET LUAN
Ty ie STTB va STKTP/DC sau 5 nam tUdng irng la 75,2%; 68%. Cd nhieu yeu to anh huidng den ket qua song them. Tinh trang di can hach va so lu'dng hach di can; So IUdng hach nach di can anh hu'dng Idn den thdi gian song ciia BN, thill gian song them ty le nghich vdi so iudng hacli nach dl can. Song them toan bp khi khdng di can hach nach 90,6%; di can >4 hach nach 39,3%.
Y HOC VIET NAM THANG 5 - SO 2/2015
TAI LIEU T H A M KHAO
1 . Biii Dieu (2003), "Ung thu'vu". Thuc hanh xa tn benh ung did. Nha xuat ban Y hoc. 327-337.
2. Thang V.H., Skoog L., Luu H.N. et al (2014),
"Long-term breast cancer survival in Vietnamese women". Breast J. 20(3): p. 333-5.
3. Tr3n Van Thuan ( 2 0 0 5 ) , "Danh gia ket qua dieu trj bd trO bang hoa chat phac do AC ket hdp vdi lieu phap noi tiet tren benh nhan UTV giai doan II-III cd thy the estrogen du'dng tinh", luan an tiS'n sy Y hgc, tri/dng dai hpc Y Ha Noi.
4. Parise C.A., Caggiano M. (2014), "Breast Cancer Survival Defined by the ER/PR/HER2 Subtypes and a Surrogate Classification according to Tumor Grade and Immunohistochemical
^\omaxV&ri\ J Cancer Epidemiol. 2014: p. 469251
Lin N.U., Vanderplas A., Hughes M.E., et al (2012), "Clinicopathologic features, patterns of recurrence, and survival among women with triple-negative breast cancer in the National Comprehensive Cancer Network". Cancer 118(22): p. 5463-72.
Gennari A., Sormani M.P., Pronzato P. et al (2008), "HER2 status and efficacy of adjuvant anthracydines in early breast cancer: a pooled analysis of randomized trials". J Natl Cancer Inst.
100(1): p. 14-20.
Livi L, Meattini I., Saieva C. et al. (2012),
"Prognostic value of positive human epidermal growth factor receptor 2 status and negative homione status in patients with Tla/Tlb, lymph node-negative breast cancer". Cancxr. 118(13): p.
3236-43
DAC DIEM LAM SANG, CAN LAM SANG UNG THIT GIAP TRANG D i r g e PHAU THUAT TAI BENH VIEN DAI HOC Y H A N O I
Tran Van Thong*, Le Van Quang**, Dinh XuSn Cirfrng***
T O M TAT
MMC tieu: Nhan xet mpt s5 dac diem lam sang, can lam sang ung thu' giap trang du'dc phau thuat tai Benh vien Dai hpc Y Ha Npi. Do! tu'dng va phu'dng phSp: nghien cuU mo ta 70 benh nhan chan doan UTTG duyc dieu til tai B$nh vien Oai hoc Y Ha Noi tiy 01/2012 den 05/2014. Ket qua: tudi trung binh la 43,27± 14,71; ty I? nam/niJ la VA; U vung c6 chiem ty le cao nhat 90%, 1 u tren lam sang 77,14%, ty le u thuy phai va thuy trai tuUng du'dng nhau. U kich thu'dc 2-4 cm chiem 54,29%, u ciitig chSc 90%, u ranh gidi ro 91,43%, u di dong 90%; hach co 32,86%. Ket qua sieu am, u TIRADS 4 chiem 71,05%, u ddn dpc 62,86%, u hai thiliy 27,14%; hach co tren sieu am la 38,57%, hach mpt ben 81,48%; Xet nghiem te bao hoc tai u du'dng tinh la 90%; 100% du'dng ti'nh tai hach. K§t l u | n : trieu chutig lam sang chu yeu cua ung thu" giap trang la sd thay u viing tuyen giap, sieu 3m viJng co v3 chpe tB bao tai u va hach co vai tro quan trpng trong chan doan.
TWkhda: Ung thu' giap tmng, lam sang, can lam sang.
* Benh vl^n Ung budu Nghe An
** Khoa Ung b&du va CSGN- Benh vien DHY Ha Noi
***BpnhvipnK Chju trach nhi^m chinh:
Email: [email protected] Dt: 0912884668 Ng^y nh|n bai: 3/3/2015
Ngay phan bien khoa hpc: 1/4/2015 Ngay duy?t biii: 6/4/2015
S U M M A R Y
THE CLINZCO-PATHOLOGICAL CHARACTERISTICS OF T H Y R O I D CANCER
WERE TREATED I N H A N O I MEDICAL U N I V E R S I T Y HOSPITAL
Objective: Remarks on the clinical characteristics, subclinical thyroid cancer treated' in Hanoi Medical University Hospital from 01/2012 to 05/2014. Subjects and Methods: 70 patients with thyroid cancer were treated at Hanoi Medical University Hospital from 01/2012 to 05/2014. The restrospective descriptive study. Results: Mean of age 43.27 ± 14.71; male: female 1/4; neck tumor accounted for the highest percentage 90%; solitary tumor was 77.14%, the ratio of the right lobe and left lobe tumors was the same; 2-4 cm sized tumor was 54.29%; 90% solitary tumors, bilateral tumor 91.43%; neck lymph nodes 32.86%; Ultrasound, TIRADS 4 tumor was 71.05%, solitary tumor was 62.86%, bilateral tumor was 27.14%; 38.57% had lymph nodes; 81.48% ipsilateral nodes. Cytologicatly, malignant tumor was 90%; 100% positive lymph node. Conclusions: Clinical palpation was the most common presentation of thyroid cancers. Neck ultrasound and lymph node/tumor fine aspiration cytology have an important role In diagnosis.
Keywords: Cancer of the thyroid, clinical, paraclinical characteristics.
