甲状腺微小乳头状癌术后个体化TSH抑制治疗效果比较

［摘要］ 〖HTH〗目的〖HTSS〗观察不同促甲状腺激素（thyroid-stimulating hormone，TSH）抑制水平下甲状腺微小乳头状癌的5年复发/转移率有无区别。 〖HTH〗方法〖HTSS〗选取甲状腺微小乳头状癌患者120例，均行手术治疗，术中冰冻病理证实为甲状腺乳头状癌后采用甲状腺全切+患侧中央区淋巴结清扫或甲状腺患侧及峡部切除+患侧中央区淋巴结清扫。术后病理证实为微小乳头状癌。分别对中危组与低危组进行不同水平的TSH抑制治疗，定期复查甲状腺超声，观察约5年。 〖HTH〗结果〖HTSS〗至5年左右随访时，中危组观察组与对照组复发/转移情况差异无统计学意义（P＞0.05），低危组观察组与对照组复发/转移情况差异也无统计学意义（P＞0.05）。 〖HTH〗结论〖HTSS〗5年内，对中、低危组甲状腺微小乳头状癌来说，应用药物替代并未增加其术后的复发/转移率。

Comparison of individualized TSH inhibition after the surgery of papillary thyroid microcarcinoma

［Abstract］Objective〖HTSS〗To observe the difference in recurrence/metastasis rate of papillary thyroid microcarcinoma patients under different thyroid-stimulating hormone（TSH） inhibition treatment within 5 years. 〖HTH〗〖WTHZ〗Methods〖HTSS〗One hundred and twenty patients with papillary thyroid microcarcinoma selected from our department were performed with surgical treatment. When the patient was confirmed to have papillary thyroid carcinoma by frozen pathology during surgery, we used total thyroidectomy and central lymph node dissection or thyroid occipital and isthmic resection and central lymph node dissection. All patients were confirmed as micropapillary carcinoma by pathological methods after the surgery. Different levels of TSH inhibition treatment were administered to the moderate-risk group and the low-risk group. Patients′ thyroids were regularly reviewed by ultrasound for about 5 years. 〖HTH〗〖WTHZ〗Results〖HTSS〗In the moderate-risk group, patients who received TSH inhibition treatment did not differ from those who received drug substitution therapy within 5 years follow-up(P＞0.05). In the low-risk group, there also was no significant difference between the TSH inhibition treatment and drug substitution therapy(P＞0.05). 〖HTH〗〖WTHZ〗Conclusion〖HTSS〗For the moderate-risk and low-risk groups of papillary thyroid microcarcinoma, drug substitution did not increase the recurrence rate after the operation within 5 years.