孕产期分化型甲状腺癌的诊治分析及手术时机探讨

Research on therapy analysis and operation timing of differentiated thyroid carcinoma diagnosed during pregnancy

目的分析孕产期分化型甲状腺癌的诊治方法及不同手术时机对妊娠的影响。方法回顾性对照分析我院普外科2001年1月至2011年1月收诊的孕产期女．陛分化型甲状腺癌47例临床资料，根据手术时机将其分为生育前组（34例）、生育后组（13例），对其临床特点及其对妊娠的影响进行评估。结果两组诊治年龄、手术方式、肿瘤病理类型、病理学TNM分期、肿瘤多灶性、包膜外侵犯、局部复发率、死亡率及分娩期并发症的差异均无统计学意义。结论孕产期分化型甲状腺癌预后良好，产后手术对患者妊娠及预后无明显影响。

Objective To analyze the therapy of differentiated thyroid cancer diagnosed during pregnancy and study the impact of different operation timing on pregnancy. Methods A retrospective a- nalysis involving 47 pregnant women with differentiated thyroid cancer from January 2001 to January 2011 in our department was performed. All cases were divided into two groups according to the operation timing （ group 1, n = 34, undergoing operation before delivery; group 2, n = 13, undergoing operation after deliver- y）, and their clinical features with influence on pregnancy were evaluated. Results There were no signifi- cant differences between the two groups in diagnosed age, operation method, histological type, TNM stag- ing, extrathyroid invasion, tumor muhifocality, cervical lymph node metastasis, recurrence rate, mortality rate and complications during delivery. Conclusion Present data indicate that pregnant women with dif- ferentiated thyroid cancer have an excellent prognosis, surgery can be safely delayed until after delivery and it has no significant impact on the pregnancy or the prognosis.