甲状腺良性疾病并存甲状腺微小癌的临床研究

目的探讨甲状腺良性疾病并存甲状腺微小癌的临床病理特征、手术方法及预后。方法回顾性分析39例甲状腺良性疾病并存甲状腺癌的临床资料。结果39例甲状腺微小癌的男女比为1∶4.5;71.8%（28/39）是术中快速病理检查发现的;97.4%（38/39）为乳头状癌;56.4%（22/39）行患侧腺叶＋峡部＋对侧腺体大部分切除术,43.6%（17/39）行患侧腺体全切术。术后随访0～10年（平均7.2年）,仅1例患者术后2年出现对侧叶复发,行腺叶切除＋中央区淋巴结清扫术后治愈,其余病例至今未见复发。结论甲状腺良性疾病并存甲状腺微小癌女性发病率较高;绝大多数为乳头状癌;多数因甲状腺良性病变手术时疑为恶变行快速病理检查发现;手术方法多为行患侧腺叶＋峡部＋对侧腺体大部切除术;预后较好。

The Clinical Study of Thyroid Microcarcinoma in Thyroid Benign Diseases: a Clinical Analysis of 39 Cases

Objective To analyze the clinical characteristics and prognosis, and to discuss the operation procedures for the thyroid microcarcinoma in thyroid benign diseases. Methods Data of 39 patients with thyroid microcarcinomas in thyroid benign diseases operated between January Jan 1999 and Jan 2009 were retrospectively reviewed. Results Male ： female = 1 ： 4.5 ; 71.8% （28/39）of all cases were identified intraoperatively by cryoseciou ;97.4% of all cases were papillary thyroid carcinoma; 92.3 % of all cases were performned with lobal and isthmus resection;43.6% （ 17/39 ） were performed with lobal resection. At a median follow - up of 7.2 years （0 - 10 years） ,one case recurred in another lobe 2 years after operation. The patient was disease free after remnant lobal resection and neck center node dissecsion. Conclusion The incidence of the thyroid microcarcinoma in thyroid benign diseases in female is higher than in male. Most cases are papillary carcinoma, and are found intraoperatively by cryosecion. The prognosis is good after lobal and isthmus resection.