术后意外甲状腺乳头状癌处理方法的探讨

Study on the treatment of postsurgical incidental papillary thyroid carcinoma

目的探讨术后意外甲状腺乳头状癌的发生原因及处理方法。方法回顾性分析2013年1月~2016年12月解放军总医院第七医学中心耳鼻咽喉头颈外科29例双侧单灶及单侧单灶术后意外甲状腺乳头状癌的病例资料,患者术中行双侧或单侧甲状腺腺叶部分切除术,术后给予促甲状腺激素(thyroid stimulating hormone,TSH)抑制治疗、定期的甲状腺彩超检查和随访。结果 29例术后病理均为甲状腺微小乳头状癌,最大径为0.7~5.0(3.8±1.3)mm,术后无喉返神经损伤或甲状旁腺功能低下等并发症,随访(66.5±15.05)个月未见肿瘤复发及中央区淋巴结转移。结论轻度的TSH抑制治疗、定期的甲状腺彩超检查、严格的密切随访可以作为术后意外甲状腺乳头状癌患者一种处理方法。

OBJECTIVE To explore the causes and treatment of postsurgical incidental papillary thyroid carcinoma.METHODS Retrospective analysis was performed on 29 cases of postsurgical incidental papillary thyroid carcinoma including bilateral unifocal or unilateral unifocal in our department during the 4 years from January 2013 to December 2016.All of them underwent bilateral or unilateral partial thyroidectomy.They received TSH inhibition therapy,regular thyroid ultrasound examination,and close follow-up.RESULTS All of the postoperative pathology was papillary thyroid microcarcinoma with a maximum diameter of 0.7-5.0(3.8±1.3)mm.There were no postoperative complications such as recurrent laryngeal nerve injury or hypoparathyroidism.The patients were followed up for (66.5±15.05)months.During the follow-up period,there were no tumor recurrence and central lymph node metastasis.CONCLUSION TSH inhibition therapy,regular thyroid ultrasound examination,and strict follow-up could be used as management method for postsurgical incidental papillary thyroid carcinoma.