102例甲状腺微小乳头状癌的诊治分析

  目的  探讨甲状腺乳头状微小癌的临床特点、诊断和外科治疗方式。   方法  回顾分析本院自2006年1月-2011年5月收治的甲状腺微小乳头状癌102例。   结果  102例中行患侧+峡部甲状腺全切67例，患侧甲状腺全切+对侧甲状腺次全切除34例，甲状腺全切1例。术前B超提示淋巴结肿大27例，术中行功能性淋巴结清扫，24例术后病理证实有淋巴结转移；术前B超阴性，术中探查淋巴结肿大12例，均行功能性淋巴结清扫术，1例术后证实有淋巴结转移。术后25例证实淋巴结转移，其余63例行中央区淋巴结清扫。随访5年，3例复发。   结论  B超可明显提高甲状腺乳头状微小癌的检出率，腺叶切除+中央区淋巴结清扫可作为主要手术方式，对临床淋巴结肿大者行同侧功能性颈淋巴结清扫术。 

Papillary Thyroid Microcarcinoma:A Clinical Analysis of 102 Cases

  Objective  To investigate the clinical characteristics and prognosis of papillary thyroid microcarcinoma (PTMC) and to discuss its resection extent.   Methods  The clinical data of 102 PTMC patients who received surgery between January 2006 and May 2011 were analyzed.   Result  A total of 67 patients underwent lobectomy, 34 underwent contralateral lobectomy, and 1 received total thyroidectomy. Moreover, 39 patients underwent functional neck dissection, and 63 underwent lymph-node dissection. Follow-up was done after 5 years, and three patients experienced recurrence.   Conclusion  Ultrasound helped in the diagnosis of papillary thyroid microcarcinoma. All PTMCs should be treated with lobectomy and lymph-node dissection, whereas some cases of clinical lymph node enlargement should be treated via functional neck dissection.