甲状腺微小癌

Microcarcinoma of the Thyroid

目的 进一步明确甲状腺微小癌的概念 ,提高对甲状腺微小癌的诊治水平。方法 回顾性分析 1995年 1月至 2 0 0 1年 12月收治的 3 5例甲状腺微小癌的临床资料。结果 所有病例均接受手术治疗并经病理学检查证实为甲状腺微小癌。 2 1例是经术中冷冻病理检查确诊 ,14例术前确诊。 4例有颈部淋巴结转移 ,1例远处转移至骨、脑。 1例术后 5年半死于骨、脑转移 ,其余患者未复发 ,均健在。结论 甲状腺微小癌起病隐匿 ,术前难确诊 ,多数经术中冷冻而获诊断。部分瘤体较小时即出现转移而预后差 ,可见瘤体虽“微小”但生物学行为并非“危小”。

Objective To achieve the better understanding of thyroid microcarcinoma and to improve the diagnosis and treatment.Methods 35 cases of thyroid microcarcinoma from Jan 1995 to Dec 2001 were collected and retrospectively reviewed.Results All of the 35 cases underwent operation and were confirmed by pathological examination.21 cases were diagnosed to be thyroid microcarcinoma by frozen section pathological examination during the operation.Only 14 cases were preoperatively diagnosed as thyroid microcarcinoma.Neck lymph node metastases were found in three cases and bone and brain metastasis in one case.Only one case died because of bone and brain metastasis 5.5 years after operation.Conclusion Preoperative diagnosis of thyroid microcarcinoma is difficult.Most of them are diagnosed by frozen section during operation.Some of them have poor prognosis because of early metastasis.Though the tumor is tiny,its biological behavior is malignant.Operation is only effective way for thyroid microcarcinoma.