甲状腺微小癌的生物学特性与诊治方式  

The biological characteristics of thyroidmicrocarcinoma and its relationship with the diagnosis and treatment

作　　者：林硕超[1] 苏国强[1] 孔德全[1] 

机构地区：[1]福建医科大学附属厦门第一医院普外科,福建厦门361003

出　　处：《赣南医学院学报》2009年第6期871-872,共2页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨甲状腺微小癌的生物学特性与诊治方式。方法:回顾性分析36例甲状腺微小癌的临床及病理资料。结果:36例甲状腺微小癌均为术前拟诊结节性甲状腺肿、甲状腺瘤及甲状腺机能亢进等良性病变,经术中冰冻并术后石蜡切片确诊微小癌。28例术前诊断结节性甲状腺肿者,26例一侧TMC者,行患侧甲状腺腺叶全切除加峡部切除及对侧腺叶次全切除术,2例双侧微小癌行甲状腺全切除,2例甲状腺机能亢进者行患侧叶加峡部切除及对侧叶大部切除术。6例甲状腺腺瘤者行患侧腺叶加峡部切除。2例活检诊断淋巴结转移者行患侧中央区淋巴结清扫术。34例获得随访6个月～10年,均无瘤生存。结论:掌握甲状腺微小癌的生物学特点利于其诊断及治疗的选择,彩色多普勒超声检查是诊断甲状腺微小癌的重要手段,患侧甲状腺腺叶全切除加峡部切除和/或对侧腺叶次全切除术为主要术式,一般不作预防性颈清扫术。Objective： To investigate the biological characteristics of thyroidmicrocarcinoma（TMC） and its relationship with the diagnosis and treatment.Methods： The clinical and pathological data of 36 cases with TMC treated from Jan.1998 to Jun.2008 were retrospectively analyzed.Results： 36 cases were diagnosed as benign thyroid diseases,including nodular goiter,thyroid adenoma and hyperthyreosis.And all 36 cases were made a definite diagnosis by freezing section and paraffin section.Homolateral lobe and isthmus tatal thyroidectomy and contralateral lobe near total thyroidectomy in 26 cases with nodular goiter complicated by unilateral TMC,total thyroidectomy in 2 patients with hibateral TMC,Homolateral lobe and isthmus tatal thyroidectomy and contralateral lobe near total thyroidectomy in the cases with hyperthyreosis,Homolateral lobe and isthmus tatal thyroidectomy in 6 cases with thyroid adenoma,Homolateral functional neck dissection ware performed in 2 cases with lymphatic metastasis.34 patients were followed-up from 6 to 120 months,all of 34 cases were alive without tumor.Conclusion： studying biological characteristics of thyroid microcarcinoma facilitates diagnosis and treatment of TMC,color Doppler ultrasonography is very important to diagnosis of TMC.Homolateral lobe and isthmus tatal thyroidectomy and /or contralateral lobe near total thyroidectomy is the main surgical method of TMC.Prophylactic neck dissection is not performed normally.

关 键 词：甲状腺微小癌 生物学特性 诊断 外科治疗 

分 类 号：R736.1[医药卫生—肿瘤]