分化型甲状腺癌的外科治疗  

Surgical treatment of differentiated thyroid carcinoma

作　　者：杨力[1] 瞿昌晶[1] 詹又华[1] 吴文美[1] 

机构地区：[1]上海市杨浦区中心医院普通外科,上海200090

出　　处：《中国普通外科杂志》2007年第11期1056-1058,共3页China Journal of General Surgery

摘　　要：目的总结分化型甲状腺癌的诊治经验。方法回顾性分析110例分化型甲状腺癌的临床资料。结果全组均行手术治疗辅以内分泌治疗,110例分化型甲状腺癌中,乳头状癌88例(80.0%),滤泡状腺癌22例(20.0%);淋巴结转移者22例(20.0%)。手术方式包括单侧病变行患侧腺叶+峡部及对侧大部切除60例(其中功能性颈清扫12例),患侧腺叶+峡部切除29例(其中功能性颈清扫7例);双侧病变行一侧腺叶+峡部及对侧大部分切除18例(其中功能性颈清扫5例),甲状腺全切除术+双侧颈清扫2例;1例肺转移患者行甲状腺全切及颈部淋巴结清扫术后行131I内放射治疗。98例术后随访,10年生存率91.8%。结论分化型甲状腺癌预后较好,治疗关键是正确选择适当的手术方式。Objective To summaize our experience in surgical treatment of differentiated thyroid carcinoma （DTC）. Methods The clinical data and follow-up results of 110 cases of DTC were retrospectively analysed. Results All of the 110 patients received operation and TSH suppression therapy. Histologic examination after operation revealed papillary thyroid carcinoma （ PTC ） in 88 cases （80 % ） , follicular thyroid carcinoma in 22 cases （ 20 % ） , and cervical lymph node metastasis was found in 22 cases （ 20 % ）. The operative procedure included excision of the affected lobe, isthmus and greater part of the opposite lobe in 51 cases （along with functional cervical dissection in 12 cases ） ; excision of the affected lobe, and isthmus in 29 cases （along with functional cervical dissection in 7 cases ） ; excision of the affected lobe, isthmus and greater part of the opposite lobe in 18 cases （ along with functional cervical dissection in 5 cases ） ; total thyroidectomy and bilateral cervical dissection in 2 cases; total thyroidectomy and bilateral cervical dissection with postoperative ~3~I therapy in 1 case who had lung metastasis. Following up of 98 cases showed the 10-year survival rate was 91. 8 %. Conclusions Differentiated thyroid carcinoma has a good prognosis. Proper selection of surgical procedure is the key point for a good outcome.

关 键 词：甲状腺肿瘤/治疗 甲状腺切除术 预后 

分 类 号：R736.1[医药卫生—肿瘤]