甲状腺微小癌的临床诊治分析

Clinical diagnosis and treatment of thyroid microcarcinoma

目的探讨甲状腺微小癌的临床诊断和治疗方法。方法回顾性分析37例甲状腺微小癌患者的临床资料。结果根据病变情况、淋巴结有无肿大以及术中术后病理切片检查结果选择手术方式。术中冰冻切片病理确诊者35例，占94．6％。术后石蜡切片病理证实为甲状腺癌2例后未追加手术，占5．4％。全组无近期手术并发症。术后随访2～5年，37例均健在，7例出现对侧叶肿瘤复发，行腺叶全切除术。1例为单侧颈淋巴结清扫术后淋巴结出现转移，行局部淋巴结清扫术。结论甲状腺微小癌以单发癌结节为主。运用B超、术中快速冰冻病理检查等方法可提高甲状腺微小癌的检出率。对甲状腺微小癌，一般主张积极手术治疗，并根据肿块的数目、分布及有无颈部淋巴结转移，选择手术方式。甲状腺微小癌手术治疗的预后较好，但术后仍需长期随访。

Objective To discuss the clinical diagnosis and treatment methods of thyroid mi Methods The materials of 37 patients suffering from thyroid microcarcinoma were analyzed. Results Of the patients, only 9 were suspected of suffering from thyroid microcarcinoma before operation, 35 were diagnosed through the frozen section drawn during the operation, accounting for 94.6% and 2 were diagnosed through pathological test after the operation, accounting for 5.4%. At the same time, 17 of them suffered from nodular goiter and 8 cervical lymphatic metastasis. Thirty-three patients received the unilateral thyroidectomy with isthmus resection as well as contralateral subtotal thyroidectomy. Two received bilateral thyroidectomy, 2 bilateral subtotal thyroidectomy with isthmus resection and 8 received functional clearance of cervical lymph nodes. After follow-up visits, it is found that all of them are still living and in good health. women and is mainly solitary cancerous nodules. Conclusions Thyroid microcarcinoma occurs more often among With type B ultrasound test and rapid pathological examination during operation, the detection rate of thyroid microcarcinoma can be improved. It is advocated to actively carry out operation and choose operation modes based on the number of tumors, the distribution conditions as well as whether there is cervical lymphatic metastasis. The prognosis of operation treatment for thyroid microcarcinoma is optimistic but long term follow-up is still needed.