甲状腺微小癌临床诊治分析

目的 探讨甲状腺微小癌的临床特征、诊断与治疗原则.方法 回顾性分析1997年1月至2006年12月收治的29例甲状腺微小癌患者的临床资料.结果 27例行术前B超检查,均发现甲状腺的微小占位,提示可疑癌5例,其中伴颈部淋巴结肿大1例经活检诊断为转移性甲状腺癌.均予手术并行术中冰冻病理检查,阳性诊断23例,6例于术后经石蜡切片病理确诊.术后均获得随访,其中2例行患侧甲状腺次全切除术的患者分别于术后2、3年复发;1例死于脑出血.结论 甲状腺微小癌术前不易确诊,术前B超及术中冰冻病理检查是主要诊断手段,患侧甲状腺加峡部切除术可作为主要手术方式,甲状腺微小癌预后较好.

Clinical analysis of diagnosis and treatment thyroid microcarcinoma

Objective To investigate the clinical characteristics,diagnosis and therapeutic principle of thyroid microcarcinoma(TMC).Metllotis Clinical data of 29 TMC cases from January 1997 to December 2006 were retrospectively analyzed.Results 27 cases were performed B-ultrasonography and minimal lesion of thyroid Was detected in all patients,5 cases were diagnosed as TMC suspiciously,of whom 1 case was found to have lymph node swell in cervical part and was diagnosed as metastasis thyroid cancer by lymph node biopsy.All cases took operation and experienced intra operative frozen section and paraffin section evaluation,indicating that 23 cases were confirmed by intra operative frozen section and 6 cases were confirmed by paraffin section.All cases were followed up after operation,of whom 2 patients undergoing homo-lateral near total thyroidectomy experienced recurrent after 2 years and 3 years operation respectively,and one patient died from cerebral hemorrhage.Conclusion Though it is difficult to confirm the diagnosis of TMC before operation,B-uhrasonography before operation combined with frozen section intra operation is the effective diagnostic method,and homolateral lobe and isthmus total thyroidectomy is the fundamental operation management.