分化型甲状腺癌的诊断和手术治疗(附285例报告)

目的 :探讨分化型甲状腺癌的诊断和治疗。方法 :对 2 85例经手术治疗的分化型甲状腺癌患者的临床资料进行回顾性分析。结果 :术前细针穿刺细胞学检查 (FNAC)结合临床确诊 4 0例 ,术中快速冰冻切片结合流式细胞术DNA倍体分析、DNA指数及S期细胞比例确诊 132例 ,术后常规病理切片确诊 113例。双侧甲状腺全切除术 2 4例 ,患侧腺叶、峡部、对侧腺叶全切除术 16 0例 ,患侧腺叶、峡部切除术 36例 ,患侧腺叶切除术 5 4例 ,患侧腺叶、峡部切除加同侧颈淋巴结清扫术 11例 ;再次手术 31例。本组无手术死亡 ,7例术后出现声嘶 ,5例出现饮水呛咳 ,2例出现抽搐。结论 :术中冰冻切片、流式细胞术DNA倍体分析、DNA指数及S期细胞比例检查有助于甲状腺癌的诊断和术式选择 ,避免二次手术可减低手术并发症

Surgical Treatment of Differentiated Thyroid Cancers A Report of 285 Cases

Objective: To investigate the diagnosis and surgical treatment of the differentiated thyroid cancers.Methods:Two hundred and eighty five cases of thyroid cancers who had undergone operation from Jan.1993 to Oct. 2002 were analyzed retrospectively.Results:Forty cases were diagnosed before operation on fine needle aspiration cytology(FNAC),based on clinical data;132 cases were diagnosed during operation on intraoperative frozen section and aneuploid,DNA index and S phase of flow cytometry(FCM);113 cases were diagnosed on postoperative paraffin section.Twenty four cases underwent a total thyroidectomy;160 cases did excision of the suffered lobe,isthmus,and greater partial of the opposite lobe; 36 cases did excision of the suffered lobe and isthmus;54 cases did excision of the suffered lobe;11 cases did excision of the suffered lobe,isthmus,greated partial of the opposite lobe, and neck dissection;31 cases did a reoperation.No death occurred after operation.7 cases showed vocal cord paralysis,5 cases showed cough throat tie due to superior laryngeal nerve injury,and 2 cases showed tie due to hypocalcemia.Conclusion:Intraoperative frozen section and aneuploid,DNA index and S phase of flow cytometry(FCM)are helpful for the diagnosis and the choice of operative methods.Relieving two stage produce could decrease complication incidence.