甲状旁腺腺瘤和腺癌的诊断与治疗  

Diagnosis and Surgical Treatment of Parathyroid Adenoma and Parathyroid Carcinoma

作　　者：魏志新[1] 

机构地区：[1]附属菏泽市立医院,山东菏泽274031

出　　处：《菏泽医学专科学校学报》2007年第2期24-25,共2页Journal of Heze Medical College

摘　　要：目的 探讨甲状旁腺腺瘤（PTS）和腺癌（PTC）诊断与外科治疗。方法回顾性分析我院自1985年3月至2007年3月收治的16例本病患者的临床病理资料。结果16例患者中，腺瘤15例，腺癌1例。血钙、血清甲状旁腺素（PTH）15例高于正常。B超定位的特异性为91．7％（11／12），^99mTc-甲氧基异丁基异腈（MIBI）的敏感性为100％（8／8）。全部病例均行病变腺体摘除，其中10例行单侧探查，5例行双侧探查，1例PTC行同侧甲状腺叶切除和同侧改良颈淋巴结清扫。术中发现下旁腺较上旁腺更易受累。全部患者临床症状在术后均得到缓解。13例获随访，随访时间3个月-22年，肿瘤无复发。结论慢性骨病和反复发作的泌尿系结石患者，应为PTA和PTC的疑诊对象，血钙、血清PTH检查是PTA和PTC可靠的定性诊断方法，B超和^99mTc—MIBI相结合可对本病获得准确的定位诊断。本病行手术治疗疗效是满意的。Objective To study the diagnosis and surgical treatment of parathyroid adenoma（PTA） and parathyroid carcinoma （PTC）. Methods A retrospective clinicopatholngic analysis was made on 16 cases of PTA and PTC admitted from March 1985 to March 2007. Results Among the 16 cases, 15 cases were of PTA and 1 cases were of PTC. The serum calcium and PTH levels were elevated in 15 cases. For locating the PTA and PTC,the specificity of B- Us was 91.7 % （ 11/12）, and the sensitivity of^99mTC- MIBI was 100 % （8/8}. Tumors resection was performed in all the 16 cases. Unilateral neck exploration was performed in 10 cases, bilateral exploration was performed in 5 cases, 1 cas with PTC ipsilateral thyroid lobe excision and modified neck dissection were also performed. We found much more tumors in inferior glands than that in superior glands. Clinical symptoms of all the patients were relieved after operation. No recurrent cas found during flow- up periods（ from 3 month to 22 years） in 13 cases. Conclusion Patients with chronic bone diseases and repeatedly recurrent nephrolithiasis should be regarded as suspicious cases of PTA and PTC. And serum calcium and PTH assays are both reliable methods for the diagnosis of PTA and PTC. A combination of B- Us and ^99mTc - MIBI scintigraphy is sufficient for locating adenomas. The surgical resection is a good treatment for these patients.

关 键 词：甲状旁腺腺瘤/诊断 甲状旁腺腺癌/诊断 甲状腺腺瘤/外科手术 甲状腺腺癌/外科手术 

分 类 号：R736.2[医药卫生—肿瘤]