目的    探讨钙化灶在桥本甲状腺炎合并甲状腺癌中的临床意义。 方法    回顾性分析华中科技大学同济医学院附属同济医院胆胰外科2001年1月至2011年12月10年间收治的184例桥本甲状腺炎及桥本甲状腺炎合并其他甲状腺疾病的临床资料（不包括既往有甲状腺手术病史的病例）。 结果    桥本甲状腺炎合并甲状腺癌病人43例（23.4%，43/184），其中伴有钙化者26例；141例桥本甲状腺炎及桥本甲状腺炎合并甲状腺良性疾病中有钙化者13例。桥本甲状腺炎合并甲状腺癌病人钙化灶发生率明显高于桥本甲状腺炎及其合并甲状 腺良性疾病者（P＜0.05）。26例恶性钙化中微小钙化22例，粗大钙化4例，微小钙化在桥本甲状腺炎合并甲状腺癌中的特异性为84.6%（22/26）。桥本甲状腺炎合并甲状腺癌病人术前穿刺细胞学诊断正确率为67.6%（25/37）。 结论    微小钙化对桥本甲状腺炎合并甲状腺癌的诊断有较高的特异性，对彩超提示有微小钙化的桥本甲状腺炎病人应积极手术探查，结合术中快速病理检查，可以有效地提高桥本甲状腺合并甲状腺癌的早期诊断率。

Clinical significance of calcification in Hashimoto's thyroiditis with thyroid cancer        LONG Guan-bao, ZHANG Chun-xia, ZHENG Jian-wei, et al. Department of Biliary-pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030,China
Correspondence author: SHEN Ming, E-mail:shen_ming75@yahoo.com.cn
Abstract    Objective    To investigate the clinical significance of calcification in Hashimoto's thyroiditis with thyroid cancer. Methods    The clinical data of 184 cases of Hashimoto's thyroiditis asscciated with thyroid cancer treated between January 2001 and December 2011 in Department of Biliary-pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (excluding cases with a history of thyroid surgery) were analyzed retrospectively. Results    Hashimoto's thyroiditis associated with thyroid cancer was in 43 cases（23.4%，43/184）, with calcification in 26 cases. Among 141 cases of Hashimoto's thyroiditis and Hashimoto's thyroiditis associated with benign thyroid diseases, 13 cases had calcifications. The ratio of calcification in Hashimoto's thyroiditis associated with thyroid cancerthe was higher than that in Hashimoto's thyroiditis associated with benign thyroid diseases (P<0.05). There were 22 cases of microcalcifications in 26 cases of malignant calcification while coarse calcifications were 3 cases. The specificity of microcalcifications ratio in Hashimoto's thyroiditis with thyroid cancer was 84.6%（22/26）.The diagnosis rate of Hashimoto's thyroiditis associated with thyroid cancer performed FNAC was 67.6%(25/37). Conclusion    Microcalcification has the high specificity for the diagnosis of Hashimoto's thyroiditis associated with thyroid cancer. Prompted Hashimoto's thyroiditis patients with microcalcifications on ultrasonography should be positive surgical exploration combined with intraoperative rapid pathological examination, which can improve the rate of early diagnosis of Hashimoto's thyroiditis associated with thyroid cancer effectively.