甲状腺癌的外科治疗  

Surgical treatment of thyriod carcinoma

作　　者：范峻 朱彤[1] 陈涛[1] 姚昌宏[2] 

机构地区：[1]上海市第八人民医院普通外科,上海200235 [2]江苏大学附属医院普通外科,江苏镇江212001

出　　处：《中国普通外科杂志》2006年第4期271-273,共3页China Journal of General Surgery

摘　　要：目的 探讨甲状腺癌的外科手术治疗的方式和效果.方法 回顾性分析1990-2005年间上海市第八人民医院和江苏大学附属医院收治的126例甲状腺癌患者的临床资料.结果 126例甲状腺癌中,乳头状腺癌94例（74.6%）,其中有2例为桥本氏病合并甲瘤和甲状腺乳头状腺癌,1例还合并有甲亢,滤泡状腺癌20例（15.9%）,髓样癌5例（4.0%）,未分化癌4例（3.2%）,恶性淋巴瘤2例（1.6%）,鳞状细胞癌1例.126例中肿瘤直径小于1 cm的甲状腺微小癌（TMC）56例,均为乳头状腺癌.术后随访5年以上78例,1～5年36例,生活质量均为良好.未分化癌4例均于术后3～6个月死亡,2例髓样癌和1例鳞状细胞癌术后1年均因肺转移死于咯血.结论 早期诊断和治疗、规范手术切除范围可避免因漏诊再次手术,术后应早期尽量替代治疗.Objective To summarize the methods and outcome of surgical treatment of thyriod carcinoma （ TC ） . Methods The clinical data of 126 cases of TC admitted between 1990 to 2005 to our 2 hospitals was analyzed. Results Among the 126 cases, there were papillary carcinoma in 94 cases （74. 5 % ） , follicular carcinoma in 20 cases （15.9 % ） , medullary carcinoma in 5 cases （4%） , anaplastic carcinoma in 4 cases（3.2% ） , lymphoma in 2 cases（1.6% ） and squamous cell carcinoma was in 1 case（0.8% ）. Thyroid microcarcinoma （TMC） was found in 56 of 126 cases and all of them were papillary carcinoma. Seventy-eight cases were followed up for more than 5 years after operation and 36 cases for 3 to 5 years, and all have good quality of life. All of the 4 cases with anaplastic carcinoma died in 3 to 6 months. Two cases with medullary carcinoma and 1 case with squamous cell carcinoma died from pulmonary metastases 1 year after operation. Conclusions For differentiated TC, surgical treatment is the ideal treatment. However, for anaplastic TC, operation is not to be recommended, the choice of treatment is radiotherapy.

关 键 词：甲状腺肿瘤 外科学 腺癌/外科学 

分 类 号：R736.1[医药卫生—肿瘤]