富碘环境下老年甲状腺恶性肿瘤临床病理特点  

Clinical and pathologic characteristics of thyroid cancer in elderly patients under the rich iodine environment

作　　者：葛睿[1] 程爱群[1] 李翔[1] 胡天华[1] 李亿程[1] 

机构地区：[1]复旦大学附属华东医院普外科,上海市200040

出　　处：《老年医学与保健》2012年第5期313-315,共3页Geriatrics & Health Care

摘　　要：目的总结最近12年老年甲状腺恶性肿瘤的发病情况、临床病理特点和诊治经验。方法回顾性分析1999年—2010年复旦大学附属华东医院收治65岁及以上甲状腺恶性肿瘤手术患者的临床病理资料。结果53例患者，平均年龄（70．1±4．3）岁，男女比为1：1．65。甲状腺乳头状癌43例，乳头-滤泡状癌1例，滤泡状癌1例，髓样癌1例，低分化癌3例，未分化癌1例，淋巴瘤2例，甲状腺血管性肉瘤1例。颈淋巴结转移9例，侵犯甲状腺外脂肪肌肉组织6例，侵犯喉返神经2例，侵犯食管1例，侵犯气管1例。双侧癌7例，多灶癌11例。甲状腺癌TNM分期：Ⅰ期29例，Ⅱ期6例，Ⅲ期5例，Ⅳ期10例。结论富碘环境下老年甲状腺癌发病、临床病理特点有新的变化，应根据患者的不同情况采取相应合理的治疗方法。老年人通常可耐受各种甲状腺手术。Objective To discuss pathogenetic condition, clinical and pathologic characteristics and treatment experience of thyroid cancer in surgical elderly patients during the past 12 years. Methods The clinical and pathologic data of old than 65 years surgical patients with thyroid cancer from 1999 to 2010 was analyzed, retrospectively. Rusults Total number of patients was 53. The average age was 70.1 and Male： Female was 1： 1.65, There were 43 cases with papillary carcinoma, 1 case with papillary-follicular carcinoma, 1 case with follicular carcinoma, 1 case with medullary carcinoma, 3 cases with poor differentiated carcinoma, Ⅰ case with undifferentiated carcinoma, 2 cases with lymphoma and 1 case with thyroid vascular sarcoma. There were 9 cases with neck lymph node metastasis, 6 cases with invasion of extrathyroidal adipose muscle tissue, 2 cases with involvement recurrent laryngeal nerve, 1 case with invasion of esophagus and 1 cases with in- vasion of trachea. There were 7 cases with bilateral cancer and 11 cases with multiple foci of cancer. Among thyroid car- cinoma, there were 29 patients with I stage, 6 patients withⅡ stage, 5 patients with Ⅲ stage and 10 patients with IV stage. Conclusion Under the rich iodine environment, there is new pathogenetic, clinical and pathologic features about thyroid cancer in elderly patients. The corresponding and reasonable treatment should be adopted according to different conditions of patients. The elderly patients usually can tolerate all kinds of thyroid operation.

关 键 词：老年人 甲状腺癌 外科手术 

分 类 号：R653[医药卫生—外科学]