家族性甲状腺乳头状微小癌8例诊治分析

目的 总结家族性甲状腺乳头状微小癌(PTMC)的临床特征和诊治方法.方法 分析2004年10月至2005年1月经手术和病理检查证实的家族性PTMC 8例患者的临床资料.结果 随访率为100%,随访时间9～13个月,平均10.8个月.无复发及死亡病例,未发现远处转移.8例患者中发生颈部淋巴结转移2例,其中可触及肿大淋巴结且病理证实为癌转移1例,未触及肿大淋巴结但病理证实为癌转移1例,均转移至同侧,均发生在颈深上组淋巴结.腺叶多发结节2例均发生颈部淋巴结转移,单发结节6例未发生颈部淋巴结转移.合并结节性甲状腺肿2例;合并慢性淋巴细胞性甲状腺炎1例.结论 PTMC多数在良性结节术中或术后病理检查发现,家族性发病罕见.术前触诊、彩色多普勒超声检查、术中探查及冰冻切片对提高PTMC的诊断非常重要.对甲状腺肿瘤高发区患者的亲属进行筛查有助于早期发现肿瘤.患侧腺叶切除术作为常规术式以避免二次手术.应根据PTMC的临床特征,选择不同术式.

Diagnosts and treatment of 8 cases of familial papillary thyroid microcarcinom

Objective To summarize the clinical characteristics.diagnosis and treatment of familial papillary thyroid microcarcinoma(PTMC).Method The clinical data of 8 cases of familial PTMC admitted from October 2004 to January 2005 were analyzed.Results All patients were followed-up during 9 to 13(mean 10.8)months. No one suffered recurrence and dead. PTMC was found in 2 cases incidentally from thyroid specimens removed for supposed benign disease, another 6 cases were doubtful of cancer before operation and were identified by frozen section.Upper deep cervical lymph nodes were involved in 2 eases with lymph node metastasis. Lymph node metastasis in eases of multifoeal cancer in the affected lobe or of both lobe was significantly higher than those in monofoccal cancer in uni-lobe. Conclusions Most of the PTMC are found among the benign nodules during operation or within the pathological specimens,and familialPTMC are rather rare. Careful palpation,color Doppler uhrasonography, exploratory operation and frozen section are very important factors to heighten diagnosis of PTMC. Lobectomy is the routine radical operation.