88例甲状腺微小乳头状癌诊治分析

Diagnosis and treatment of thyroid papillary microcarcinoma: An analysis of 88 cases

目的探讨甲状腺微小乳头状癌的临床诊疗特点。方法回顾性分析我科2008年1月-2012年1月收治的88例经病理证实的甲状腺微小乳头状癌患者的病例资料。结果 88例术前均行颈部超声或超声引导下细针穿刺活检,漏诊率为15.9%,术中冰冻检查漏诊率为6.6%。所有患者均行手术治疗,5例行治疗性中央区淋巴结清扫,6例行预防性中央区淋巴结清扫,术后证实颈部淋巴结转移5例。所有患者术后均口服优甲乐片。随访3~56个月,仅2例复发。结论应重视甲状腺微小乳头状癌的特点,正确诊断及规范术式是治疗本病的关键。

Objective To study the diagnosis and treatment of thyroid papillary microcarcinoma（TPMC）.Methods Clinical data about 88 pathology-confirmed TPMC patients admitted to our department from January 2008 to January 2012 were retrospectively analyzed.Results The TPMC patients were diagnosed by fine needle biopsy under ultrasonic guidance,with a missed diagnosis rate of 15.9% and an intraoperative fast freezing missed diagnosis rate of 6.6%.Of the patients who underwent surgical treatment,5 underwent therapeutic central compartment lymph node dissection,6 underwent prophylactic central compartment lymph node dissection,and 5 were eventually diagnosed with cervical metastasis.The patients were treated with oral euthyrox tablets after operation and followed up for 3-56 months during which TPMC recurred only in 2 patients.Conclusion Attention should be paid to the clinical features of TPMC.Correct diagnosis and standard procedure are the key to its treatment.