结节性甲状腺肿合并甲状腺微小癌41例分析

Analysis of 41 cases of nodular goiter with thyroid microcarcinoma

目的:探讨甲状腺微小癌(TMC)的早期诊断方法及其治疗方式。方法:回顾分析41例结节性甲状腺肿合并TMC患者的临床资料,比较其彩超表现、冰冻及石蜡切片病理结果以及手术方式。结果:甲状腺彩超可作为TMC早期诊断的重要检查项目。2例多发性TMC,行双侧甲状腺腺叶+峡部+气管旁淋巴结清扫术后18个月,1例出现颈部淋巴结转移。无死亡病例。结论:甲状腺彩超可重点关注甲状腺结节的微钙化、形态及血流,对多发性TMC应采用更加积极的手术策略。

Objective： To explore early diagnosis and treatment of thyroid micro-carcinoma（TMC）. Methods： The clinical data of 41 patients with nodular goiter combined TMC was retrospectively analyzed,meanwhile color Doppler performance,rapid intra-operative frozen and paraffin section after operation,and the surgical approach were also compared. Results： Thyroid ultrasound could be an important method in the early diagnosis of the TMC,one case had cervical lymph node metastasis in 18 months later with multifocal underwent total thyroidectomy plus paratracheal lymph node dissection. Conclusion： Colour Doppler ultrasound can focus on the microcalcifications,morphology and blood flow of the thyroid nodules,TMC with multifocal should be treated with more aggressive surgery.