甲状腺微小癌46例诊治分析

Analysis of Diagnosis and Treatment of 46 Cases with Thyroid Microcarcinoma

目的分析甲状腺微小癌的临床特征和预后,并探讨其手术切除范围。方法回顾性分析1997年1月～2005年12月经手术和病理证实的46例甲状腺微小癌的临床资料。结果全部手术治疗。术后病理检查确诊甲状腺微小癌46例,其中术中冰冻切片未发现1例;4例作患侧甲状腺叶加对侧甲状腺次全切除和双侧甲状腺全切除术,40例行患侧腺叶及峡部切除,2例行患侧腺叶及峡部切除加改良性颈部淋巴结清扫。随访率100%,随访时间1～10年,1例对侧复发,无1例死亡。结论掌握甲状腺微小癌的特点,仔细检查、早期诊断和手术,预后良好。甲状腺腺叶切除作为主要手术方式,对颈部淋巴结肿大者可行同侧功能性颈淋巴结清扫术。

Objective To analyze the clinical characteristics and prognosis, and explore the resection extent for pap-illary thyroid ma. Methods To analyze and follow-up the clinical data 46 cases of papillary thyroid microcarcinomas operated from January 1997 to December 2005. Results All of 46 cases had been operated.Through postoperative pathologic exam, 46 cases were confirmed as TMC that was not discovered in I case by intraoperative freezing section.Near total thyroidectomy was performed in 4 cases.Lobectomy of one lobe in 42 cases, combined with cervical lymph node dissection were adopted in 2 cases. Follow-up rate was 100% with time ranging from 1 year to 10 years.One case recurred on opposite side and without mortality. Conclusion Understanding of the clinical features of throid microcarcinoma,careful inspection and early diagnosis and operation, contribute to the better prognosis in patients with thyroid microcarcinoma.Thyroid lobectomy is the main surgical principle. Homo-lateral unctional neck dissection should be taken for patients with neck lymph node mastastasis.