甲状腺髓样癌102例临床病理回顾性分析

Clinical analysis of 102 cases of medullary thyroid carcinoma

目的:探讨甲状腺髓样癌(me-dullary thyroid carcinoma,MTC)的临床特点、诊断和治疗方法。方法:回顾性分析1980-01-2000-12在中山大学肿瘤防治中心收治的102例MTC的临床资料。结果:本组患者大多以颈部肿物就诊。治疗方法以切除患侧腺叶加峡部为主,合并淋巴结转移者,行颈淋巴结清除及纵隔淋巴结清除术。全部患者均经病理证实为MTC;总的颈淋巴结转移率为56.9%(58/102),临床N0颈淋巴结隐性转移率为40.9%(中央区和侧颈转移率分别为40.7%和26.8%)。本组患者总的5、10和15年生存率分别为87.4%、74.6%和54.2%。结论:MTC术前确诊困难,颈淋巴结转移率高,选择合理的外科手术治疗可取得较满意疗效,减少并发症。

OBJECTIVE： To explore the clinical characteristics, diagnosis and therapy of thyroid carcinoma. METHODS： Clinical data of 102 medullary thyroid carcinoma between Jan. 1980 and Dec. 2000 were retrospectively reviewed. RESULTS： Most cases complained of cervical lump on the first visit. They were mainly treated with re moval of the affected thyroid lobe with isthmus resection, and neck dissection and mediastinal dissection was performed on those who had cervical and mediastinal metastasis. The overall cervical lymph node metastasis rate was 56.9% （58/102）. The cervical occult nodal me tastasis rate in clinically No patients was 40.9% （occult metastasis rates in central and lateral cervical regions were 40.7% and 26.8% respectively）. Overall survival rates of 5-, 10 and 15 year were 87.4%, 74.6% and 54.2% respectively. CONCLUSIONS： Medul lary thyroid carcinoma is difficult to diagnose before operation and has high frequency of cervical lymph node metastases. The optimal operation selection for medullary thyroid carcinoma may improve the quality of life and decrease the incidence of complications.