摘要
目的分析甲状腺微小癌的临床特征,并探讨其诊断及手术治疗方法。方法回顾性分析分析2003—2008年经手术和病理证实的52例甲状腺微小癌临床资料。结果术后病理检查确诊甲状腺微小癌52例,其中术中冷冻切片发现30例,准确率57.7%,未发现22例。术前B超检查48例为实质性结节(92.31%),边界不清楚,4例为含液性病灶,19例(35.19%)有细砂粒样钙化;B超术前诊断甲状腺癌11例。38例行患侧甲状腺叶切除加对侧甲状腺次全切除,3例双侧甲状腺全切除术,3例行双侧甲状腺次全切除,患侧全切除5例,3例加行一侧改良性颈部淋巴结清扫。27例cN1行中央组淋巴结清扫,转移率11/27(40.74%),其余25例cN0未探及中央组淋巴结而未行清扫。随访率96.2%,随访时间3个月至5年,无1例复发及死亡。结论(1)术前B超为首选检查。(2)对甲状腺微小癌,主张行患侧腺叶全切加峡部切除及对侧腺叶次全切除,并行中央组淋巴结清扫。
Objective To analyze the clinical characteristics, diagnosis and treatment of thyroid micro- carcinoma. Methods The clinical data of 52 cases of thyroid micro-carcinoma operated from 2003 to 2008 were analyzed retrospectively. Results All of the 52 cases were confirmed as thyroid micro-carcinoma by postoperative pathologic exam ; 30 cases （ 57.7 % ） were discovered by intraoperative frozen section and 22 cases were not. Micro-calcification ratio on ultrasound was 35. 19%. 11 cases were diagnosed as malignant tumor on ultrasound scan preoperatively. Lobectomy of involved lobe with subtotal thyroidectomy of contralateral lobe was performed in 38 cases, 3 cases of bilateral total thyroidectomy, 3 cases of unilateral lobectomy and isthmectomy, 5 cases of ipsilateral subtotal lobectomy and 3 cases of ipsilateral lobectomy with istbmectomy were performed. Combined central region lymph nodes dissection was adopted in 27 cases （positive 11/27,40.74% ）. Follow-up rate was 96. 2% , with time ranging from 3 months to 5 years. No recurrence or mortality was discovered. Conclusions （ 1 ） B type ultrasound is the first choice for preoperative screening. （2） lpsilateral thyroid lobectomy with contralateral subtotal thyroideetomy combined with central region lymph node dissection is advocated.
出处
《中国普通外科杂志》
CAS
CSCD
2008年第11期1058-1060,共3页
China Journal of General Surgery
