隐匿性甲状腺癌68例诊治分析

Analysis of Diagnosis and Treatment of 49 Cases with Occult Thyroid Carcinoma

目的探讨隐匿性甲状腺癌的临床特征及诊断和治疗方法。方法对近5年本院诊治的68例隐匿性甲状腺癌患者的临床资料进行回顾性分析。结果 B超检查偶然发现甲状腺占位21例。术前B超检查诊为甲状腺癌或怀疑恶变41(41/62,66%)例。术前经64层螺旋CT薄层扫描检查49例,诊断甲状腺癌或怀疑恶变37(75%)例。术中均行冰冻切片,其中术中冰冻切片确诊57(57/62,92%)例,可疑恶变3例,假阴性2(3%)例。结论 B超检查是筛查和发现甲状腺病变的首选方法,CT薄层增强扫描对隐匿性甲状腺癌的术前临床诊断具有重要价值。术中冰冻切片检查可提高诊断率,减少漏诊。分化型隐匿性甲状腺癌临床上恶性程度低,生长缓慢,治疗效果好。手术治疗是分化型隐匿性甲状腺癌的主要治疗手段。

Objective To investigate the clinical characteristic of occult thyroid carcinoma,and to discuss its diagnosis and treatments.Methods The data of 68patients with occult thyroid carcinoma being managed at our institution from 2005 to 2010 were retrospectively reviewed and analysed.Results B-ultrasonography examination came across 21cases of thyroid lesions.That 41（41/62,66%） cases were confirmed or suspected thyroid cancer by preoperative B-ultrasonography examination.49patients were check up by enhanced CT thin slice scan,and 37（75%） cases were confirmed occult thyroid carcinoma.Intraoperative frozen section confirmed 57（57/62,92%） case,suspected malignancy in 3cases,false-negative 2（3%） cases.Conclusion B-ultrasonography is preferred method to check up and discover for thyroid lesions.Enhanced CT thin slice scan is a significant and valuable method in preoperative diagnosis for occult thyroid carcinoma.Intraoperative frozen section examination can increase the rate of confirmed diagnosis and reduce misdiagnosis.Surgical therapy was the main means for occult thyroid carcinoma.