甲状腺癌的诊断治疗

目的探讨甲状腺癌诊断及治疗方法。方法回顾性分析我院2002—2008年行手术治疗的甲状腺癌患者236例的临床资料。结果本组患者术前B超检查发现甲状腺内实性或囊实性结节2 2 5例(9 5.5 3%),结节内伴微钙化灶者7 8例(3 3.0 5%);B超引导下细针穿刺活检8 1例,阳性率8 7.6 5%;术中冰冻切片检查2 2 1例,诊断甲状腺癌2 0 8例,阳性率9 4.1 1%;术后病理检查证实有淋巴结转移者为6 8例(2 8.8 1%)。行甲状腺部分切除1 5例,患侧叶全切4 4例,根治性切除1 7 7例。因误诊行甲状腺癌局部或患侧叶切除术后确诊行二次以上手术者2 5例,残癌率为5 6.0%(1 4/2 5)。结论 B超检查提示甲状腺结节内微钙化灶对甲状腺癌诊断有重要提示意义,结合B超引导下细针穿刺活检可明显提高术前诊断准确率,术中冰冻切片检查是确诊甲状腺癌的重要方法。患叶全切+峡部全切+对侧大部切除+选择性颈清扫术是甲状腺癌的主要手术方式。对术中误诊术后确诊者应及早行二次手术。

Diagnosis and treatment of thyroid cancer

Objective To investigate the diagnosis and treatment of thyroid cancer.Methods Retrospective analysis of the clinical data of 236 patients with thyroid cancer who underwent surgical treatment in our hospital from 2002-2008 was conducted.Results Solid thyroid nodules or cystic-solid nodules were found in 225 patients(95.53%) by B-ultrasonography(BUS) preoperatively,among them,micro-calcification within nodules was found in 78 cases(33.05%).B ultrasound-guided fine-needle aspiration biopsy was performed in 81...