甲状腺癌的外科治疗

目的 探讨甲状腺癌的外科手术治疗的方式和效果.方法 回顾性分析1990-2005年间上海市第八人民医院和江苏大学附属医院收治的126例甲状腺癌患者的临床资料.结果 126例甲状腺癌中,乳头状腺癌94例（74.6%）,其中有2例为桥本氏病合并甲瘤和甲状腺乳头状腺癌,1例还合并有甲亢,滤泡状腺癌20例（15.9%）,髓样癌5例（4.0%）,未分化癌4例（3.2%）,恶性淋巴瘤2例（1.6%）,鳞状细胞癌1例.126例中肿瘤直径小于1 cm的甲状腺微小癌（TMC）56例,均为乳头状腺癌.术后随访5年以上78例,1～5年36例,生活质量均为良好.未分化癌4例均于术后3～6个月死亡,2例髓样癌和1例鳞状细胞癌术后1年均因肺转移死于咯血.结论 早期诊断和治疗、规范手术切除范围可避免因漏诊再次手术,术后应早期尽量替代治疗.

Surgical treatment of thyriod carcinoma

Objective To summarize the methods and outcome of surgical treatment of thyriod carcinoma(TC).Methods The clinical data of 126 cases of TC admitted between 1990 to 2005 to our 2 hospitals was analyzed.Results Among the 126 cases,there were papillary carcinoma in 94 cases(74.5%),follicular carcinoma in 20 cases(15.9%),medullary carcinoma in 5 cases(4%),anaplastic carcinoma in 4 cases(3.2%),lymphoma in 2 cases(1.6%) and squamous cell carcinoma was in 1 case(0.8%).Thyroid microcarcinoma(TMC) was found in 56 of 126 cases and all of them were papillary carcinoma.(Seventy)-eight cases were followed up for more than 5 years after operation and 36 cases for 3 to 5 years,and all have good quality of life.All of the 4 cases with anaplastic carcinoma died in 3 to 6 months.Two cases with medullary carcinoma and 1 case with squamous cell carcinoma died from pulmonary metastases 1 year after operation.Conclusions For differentiated TC,surgical treatment is the ideal treatment.However,for(anaplastic) TC,operation is not to be recommended,the choice of treatment is radiotherapy.