甲状腺微小癌30例临床分析

目的总结甲状腺微小癌的诊治经验。方法回顾性分析手术治疗30例甲状腺微小癌的临床资料。结果术前经高分辨率甲状腺超声发现6例并经细针穿刺细胞学检查（FNAC）疑为甲状腺微小癌，余24例均于术中冰冻和术后病理确诊。18例合并甲状腺良性疾病。伴颈淋巴结转移6例。25例单发癌，5例多发癌，随访1．12年，平均6年，复发2例，无死亡。结论甲状腺微小癌起病隐匿，术前较难诊断，且易漏诊。应综合运用彩超、细针穿刺细胞学检查（FNAC）、术中快速冰冻病理检查、提高甲状腺微小癌的检出率。手术时应行患侧腺叶及峡部切除术，有淋巴结转移者行功能性淋巴结清扫术，预后较好，但术后仍需长期随访。

Thyroid microcarcinoma: a clinical analysis of 30 cases

Objective To investigate the diagnosis and treatment of thyroid microcarcinoma.Methods We analyzed 30 patients with thyroid microcarcinoma retrospectively.Results Before the discovery of the high resolution 6 cases of thyroid ultrasound and fine-needle aspiration biopsy(FNAC)suspected small Carcinoma of the thyroid,another 24 cases were in the Intraoperative frozen and postoperative pathologic confirmed.18 patients with benign thyroid disease.With 6 cases of cervical lymph node metastasis.25 cases of solitary cancer,5 cases of many cancers,follow-up of 1-12 years,an average of 6 years,2 cases of recurrent,no death.Conclusion Microcarcinoma onset was concealed,preoperative diagnosis more difficult,and easily missed.Integrated use of various diagnostic techniques,such as color doppler,fine-needle aspiration biopsy,intraoperative rapid frozen section diagnosis can improve the diagnostic rate.The first operation in which row affected side lobe and isthmus resection,lymph node metastasis rows functional lymph node dissection can achieve better results.Long-term follow-up after operative is needed.