隐匿性甲状腺癌72例临床分析

目的 分析隐匿性甲状腺癌的临床特点,探讨其临床诊断和治疗方法.方法 回顾分析72例隐匿性甲状腺癌的临床与病理资料.结果 术前拟诊为甲状腺微小癌69例,术后慢速病理结果:乳头状腺癌55例,髓样癌12例,滤泡状癌5例,诊断准确率为95.8％ (69/72).颈淋巴结转移癌均位于同侧,共13例.72例患者均接受患侧甲状腺全切术十峡部切除术,加做对侧部分切除者15例,13例接受颈淋巴结清扫术.所有患者均获得随访,随访1～13年,死亡2例.结论 高频超声、细针穿刺及术中冷冻切片检查转移可提高隐匿性甲状腺癌诊断率.无淋巴结转移者患侧甲状腺全切十峡部切除已足够,伴颈淋巴结转者需加行颈清扫术.

CLINICAL ANALYSIS OF 72 CASES OF OCCULT THYROID CARCINOMA

Objective To explore the clinical features of occult thyroid carcinoma(OTC) and its diagnosis and treatment.Methods The clinical and pathological data of 72 cases of OTC were analyzed retrospectively.Results Of the 69 cases of preoperative suspected thyroid minimum cancer,55 cases were pathologically confirmed as papillary thyroid carcinoma,12 as encephaloid cancer,and 5 as follicular thyroid cancer,with the diagnostic accuracy being 95.8%.All the 13 cases of cervical lymph node metastasis tumors were found at the same side.72 cases underwent total thyroidectomy and isthmectomy.15 cases received counter-lateral partial resection and 13 cases received radical neck dissection.Follow-up surveys for all patients were conducted for 1-3 years.2 cases died.Conclusion High-frequency ultrasound,fine needle aspiration and metastasis examination of cryostat sections can effectively promote the diagnosis rate of OTC.Total thyroidectomy and isthmectomy can produce good curative effect for the patients without cervical lymph node metastasis,but those complicated with cervical lymph node metastasis need radical neck dissection.