47例甲状腺微小癌诊治分析

Diagnosis and Treatment Analysis for 47 Cases of Thyroid Minimal Cancer

目的:探讨甲状腺微小癌的临床诊断和治疗方法。方法:对诊断明确的47例甲状腺微小癌进行回顾性分析。结果:术前仅12例疑为甲状腺癌,余35例均于术中冰冻和术后病理确诊。34例合并甲状腺良性疾病,伴颈淋巴结转移3例。47例中有11例术后无瘤生存时间≥10年,24例术后无瘤生存时间≥5年。结论:甲状腺微小癌术前不易确诊,且易漏诊,对甲状腺良性疾病手术时应仔细触诊,对可疑结节行冰冻切片。首次手术应行患侧腺叶及峡部切除术,有淋巴结转移者行功能性淋巴结清扫术可取得较好疗效。

Objective： To summarize clinical diagnosis for thyroid minimal cancer and its therapeutic experience. Methods： Retrospectively analyse 47 cases with thyroid minimal cancer that are diagnosed definitely. Results： In the 47 cases with thyroid minimal cancer, only 12 cases is suspect to have thyroid cancer before operation,the rest 35 cases are diagnosed definitely during the operation and postoperative pathologic diagnosis. 34 cases have complication of it no-malignancy,and 3 cases were accompanied by cervical part lymph nod metastasis. Among 47 cases, no-neoplasia survival time is for 11 cases ≥10 years after operation and that of 24 cases is ≥ 5 years. Conclusion.. Thyroid minimal cancer is not diagnosed easily and sometimes misdiagnosed. To thyroid no-malignancy diseases, palpatio should be used carefully during the operation and ultra cryotomy should be made to the suspected nod. The first-time operation should be on the side of gland and pharyx ectomy,and for patients with lymph nod matastasis cervical lymph nod clearance operation should be done. Thereby better effects can be gained. The routing cerrical lymph nod clearance operation seems uncessany.