甲状腺微小癌(附71例报告)

Microcarcinoma of the thyroid:a report of 71 cases.

目的探讨甲状腺微小癌诊断和外科治疗的经验。方法总结１９８５年１月至１９９８年８月间经手术和病理证实的甲状腺微小癌７１例。结果仅有５例术前诊断微小癌并由病理证实，３例出现颈淋巴结转移，１例骨转移。２６例行一侧腺叶全切除加对侧次全切除术，３例加颈淋巴结清扫术，其余行一侧腺叶全切除和一侧或两侧腺叶次全切除。随访病例中，术后复发１例（１６％），无一例死亡。结论甲状腺微小癌发生率较高，提高术前、术中的诊断率有助于决定治疗方案，微小癌应予以手术切除。

Objective To study the experience in the diagnosis and surgical treatment of thyroid microcarcinoma.Methods 71 cases of thyroid microcarcinoma operated from Jan 1985 to Aug 1998 were reported.Results Only 5 cases were preoperatively diagnosed as microcarcinoma and confirmed by pathological exam.Neck lymph node metastasis was found in 3 cases and bone metastasis in one case.Total thyroidectomy of the affected lobe and subtotal thyroidectomy of the opposite lobe were performed on 26 cases with neck dissection in 3 cases.The others accepted total lobectomy,bilateral or unilateral lobectomy.The postoperative recurrence was found in one case(1 6%)in follow-up cases.No one died.Conclusion Incidence rate of the thyroid microcarcinoma is higher.To improve the diagnostic rate before and after operation will help to select the therapeutic methods.Microcarcinoma should be removed.