甲状腺微癌47例临床分析

目的：探讨甲状腺微癌的诊治经验和生物学行为。方法：对我院近10年来收治的47例甲状腺微癌进行回顾性分析。结果：女性40例,男性7例,女：男5.7：1。以甲状腺结节就诊的29例,在健康查体中超声发现甲状腺结节18例。发现结节到就诊时间最长15年。手术前47例均行甲状腺彩色超声检查,其中30例提示甲状腺结节内存在钙化呈细砂粒状。术前行甲状腺结节穿刺19例,有8例诊断为甲状腺癌,4例诊断为甲状腺腺瘤,5例诊断为甲状腺肿,2例诊断为桥本氏甲状腺炎。手术行冰冻快速病理诊断43例（包括术前8例）,误诊4例。结论：甲状腺微癌误诊率较高,彩色超声显示甲状腺结节内细砂粒样钙化对甲状腺微癌的诊断有重要的参考价值。对甲状腺微癌的手术治疗应与甲状腺癌一样对待,甲状腺微癌同样有较高的转移率。

A clinical analysis of 47 thyroid microcancer cases

Objective：To explore the diagnosis and treatment of pecularity thyroid microcancer.Methods：The clinical data of 47 cases in our hospital during a period of ten years which diagnosed thyroid microcancer were analyzed retrospectively.Result：There were 40 cases of female,7 cases male,female：male,5.7：1.There were 29 cases because of thyroid nodule to see doctors,18 cases were found thyroid nodule by ultrasonography.The longest consultation time was 15 years since found the thyroid nodule.We found calcification like sand in thyroid nodule in 30 cases.19 cases had thyroid paracentesis before surgery,8 cases were diagnosed as cancer of thyroid,4 cases diagnosed as adenoma of thyroid,5 cases diagnosed as struma and 2 cases hashimoto＇s thyroiditis.43 cases had quick frozen pathologic diagnosis（included 8 cases before surgery）,Errors diagnostic happened in 4 cases.Conclusion：Mistake diagnose rate in thyroid microcancer is higher calcification like sand in thyroid nodule is very important for diagnosis of thyroid microcancer.As thyroid microcancer have high metastatic rate,so we should pay more attention.