64例甲状腺微小癌的诊治分析

Analysis of Diagnosis and Treatment in 64 Cases of Thyroid Microcarcinoma

目的探讨甲状腺微小癌(thyroid microcarcinoma,TMC)的诊断和治疗原则。方法回顾性分析本院诊治的64例TMC。结果 18例经高分辨率超声检出,6例外院术后病理确诊来我院行根治术,40例因求治甲状腺其他疾病而被发现;所有患者均行手术治疗,术中行冰冻切片检查;术后予以优甲乐口服;1例行甲状腺患侧叶切除患者2年随诊时发现同侧颈部淋巴结转移,行功能性颈淋巴结清扫术,所有患者仍健在。结论 TMC女性发病较高,以单侧为主;对临床单发结节和结节性甲状腺肿需引起重视,定期观察;超声检查在TMC的诊断中具有优势,能够早期发现,术中冰冻切片检查必不可少;合理的术式能避免过度治疗;恰当的术后治疗,能防止复发。

Objective To explore the diagnosis and treatment of thyroid microcarcinoma（TMC）.Methods 64 patients with TMC were analyzed retrospectively.Results 18 cases were diagnosed by ultrasonic;6 cases diagnosed by postoperative pathology in other hospitals were received radical resection in our hospital;40 cases were diagnosed to have other thyroid diseases.All the cases were threated by operations and detected by frozen section.Euthyrox was taken orally after operation.One case with diseased side thyroidectomy was found to be homonymy cervical lymph nody metastasis,and received functional radical neck dissection.All the cases were survival.Conclusion The mobility of female is higher in TMC and it is primary in one side.We should pay attention to single nodus and nodular goiter and should object them regularly.The detection of ultrasonic has special superiority in TMC.It can find TMC early,and the frozen section is essential during operation.The reasonable operation method can avoid excessive therapy,and the correct postoperative therapy can avoid recurring.