分化型甲状腺癌的外科治疗

目的总结分化型甲状腺癌的诊治经验。方法回顾性分析110例分化型甲状腺癌的临床资料。结果全组均行手术治疗辅以内分泌治疗,110例分化型甲状腺癌中,乳头状癌88例(80.0%),滤泡状腺癌22例(20.0%);淋巴结转移者22例(20.0%)。手术方式包括单侧病变行患侧腺叶 峡部及对侧大部切除60例(其中功能性颈清扫12例),患侧腺叶 峡部切除29例(其中功能性颈清扫7例);双侧病变行一侧腺叶 峡部及对侧大部分切除18例(其中功能性颈清扫5例),甲状腺全切除术 双侧颈清扫2例;1例肺转移患者行甲状腺全切及颈部淋巴结清扫术后行131I内放射治疗。98例术后随访,10年生存率91.8%。结论分化型甲状腺癌预后较好,治疗关键是正确选择适当的手术方式。

Surgical treatment of differentiated thyroid carcinoma

Objective To summaize our experience in surgical treatment of differentiated thyroid carcinoma(DTC).Methods The clinical data and follow-up results of 110 cases of DTC were retrospectively analysed.Results All of the 110 patients received operation and TSH suppression therapy.Histologic examination after operation revealed papillary thyroid carcinoma(PTC) in 88 cases(80%),follicular thyroid carcinoma in 22 cases(20%),and cervical lymph node metastasis was found in 22 cases(20%).The operative procedure included excision of the affected lobe,isthmus and greater part of the opposite lobe in 51 cases(along with functional cervical dissection in 12 cases);excision of the affected lobe,and isthmus in 29 cases(along with functional cervical dissection in 7 cases);excision of the affected lobe,isthmus and greater part of the opposite lobe in 18 cases(along with functional cervical dissection in 5 cases);total thyroidectomy and bilateral cervical dissection in 2 cases;total thyroidectomy and bilateral cervical dissection with postoperative 131I therapy in 1 case who had lung metastasis.Following up of 98 cases showed the 10-year survival rate was 91.8%.Conclusions Differentiated thyroid carcinoma has a good prognosis.Proper selection of surgical procedure is the key point for a good outcome.