甲状腺髓样癌的病理生物学行为与临床处理

Clinical and pathological analysis of medullary thyroid carcinoma

目的 探讨甲状腺髓样癌 (MTC)的病理学特点 ,诊断和治疗选择。方法 对 1982～ 2 0 0 1年经治的 32例MTC的临床和病理资料进行分析总结。结果 32例均予手术切除原发灶或加行颈淋巴结清扫术。均经病理证实 ,淋巴结转移率为 6 5 4%。术后 5年、10年生存率分别为 77 8%,6 2 5 %。结论 MTC具有多分化肿瘤的特点 ,可产生多种神经内分泌物质 ,少数病人可出现类癌综合征或顽固性腹泻。MTC的治疗以根治性切除为原则 ,而且要比其他类型的甲状腺癌更为积极 ,决不可任意缩小手术范围。

Objective To study the pathological characteristics, diagnosis and treatment of medullary thyroid carcinoma (MTC). Methods Clinical and pathological data of 32 cases of MTC were observed and analyzed retrospectively.Results Primary tumor resection or combined with cervical lymph node dissection were adopted in 32 cases.All cases were verified by pathology,in which the rate of lymph node metastasis was 65.4%.The survival rate of 5 and 10 years was 77.8% and 62.5%,respectively.Conclusion MTC has the characteristics of multiple differentiation tumor,which can produce numerous hormones,even manifest carcinoid syndrome or refractory diarrhea.Radical dissection is the principal treatment of MTC,moreover,operation should be more extensively performed in MTC than in other kinds of thyroid carcinoma.