结节性甲状腺肿合并甲状腺微小癌146例临床分析

Clinical Research of Nodular Goiter with Thyroid Microcarcinoma

目的分析结节性甲状腺肿合并甲状腺微小癌临床的诊断治疗和预后.方法回顾性分析自1995年1月至2004年1月期间手术治疗的146例结节性甲状腺肿合并甲状腺微小癌的临床资料.结果均行癌侧叶全切除加峡部切除,对侧叶部分或次全切除,行中央区淋巴结清扫76例,术后经病理证实7例发现有颈淋巴结转移(占9.21%);146例甲状腺乳头状微小癌患者10 a生存率为93.9%,单因素分析提示首诊时年龄≥40岁显著影响甲状腺乳头状微小癌患者的预后(P<0.05).结论结节性甲状腺肿合并甲状腺微小癌临床常见,术前诊断困难,预后较好,但年龄≥40岁预后较差.

Objective To study the diagnosis, treatment and prognosis of nodular goiter with thyroid microcarcinoma （TMC）. Method We retrospectively analyzed the clinical data of 146 cases of nodular goiter with thyroid microcarcinoma in our department between January 1995 and January 2004. Results All patients underwent monolateral thyroid lobectomy and isthmus resection. 76 patients underwent central lymph node dissection, with 7 cases of positive lymph node, the metastasis rate was 9.21. The overall 10 year survival rate of all 146 patients with papillary thyroid microcarcinoma was 93.9%. Single factor analysis showed that patients over 40 years at the first diagnosis had poor prognosis. Conclusion Nodular goiter with thyroid microcarcinoma is common in clinic, but the diagnosis is diffcuh, the prognosis is better except for patients over 40 years.