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作 者:顾禾[1] 郭源[1] 付荣湛[1] 张丽丽[2] 于学智[2]
机构地区:[1]山东省千佛山医院普外科 [2]山东大学临床学院,山东济南250014
出 处:《肿瘤防治杂志》2002年第6期609-612,共4页China Journal of Cancer Prevention and Treatment
摘 要:目的 :探讨分化型甲状腺癌的有效治疗手段。方法 :对 173例分化型腺癌的回顾性分析 ,研究病程、肿瘤大小、组织学类型、淋巴结转移、肿瘤分期、分级以及治疗方法的选择。结果 :分化型甲状腺癌占甲状腺癌总数的 83 3% (173 2 0 8) ,其中T0 、Ⅰ期占 8 1% (14 173) ,Ⅱ期占 4 1 0 % (71 173) ,Ⅲ期占5 0 9% (88 173)。共行颈淋巴结清除手术 77例 ,其中Ⅱ期 11例 ,均未查见转移淋巴结 ;Ⅲ期 6 6例 ,淋巴结转移率 10 0 %。随访 5年以上者占 5 2 6 % (91 173) ,5年复发率为 7 7% (7 91)。结论 :分化型甲状腺癌手术加内分泌治疗效果较好 ,放疗及化疗效果较差。Ⅰ、Ⅱ期病例可行患侧腺叶加峡部切除 ,Ⅲ期病例需加做改良式颈淋巴结清除术。Objective To study the clinical character and suitable treatment in differentiated thyroid cancer.Methods 173 patients with thyroid differentiated carcinoma from September 1983 to June 1999 analysed retrospectiuely.The relationship between the patients prognosis with tumor size,course of disease,type of histology,lymph nodes metastasis,tumor grade and treatment were studied.Results Of 173 differentiated thyroid carcinoma patients,stage Ⅰ and T 0 were 8 1%(14/173),stage Ⅱ were 41 0%(71/173),stage Ⅲ were 50 9%(88/173).Modified neck dissection was performed in 77(44%) cases,no positive metastasis lymph node was found in 11 cases stage Ⅱ patients,positive metastasis lymph nodes were all found in 66 cases with stage Ⅲ.52 6%(91/173) patients have been followed up more than 5 years,7 (7 7%) of them recurred.Conclusions Operation and endocrinotherapy made good results to differentiated thyroid carcinoma.Radiotherapy and chemotherapy got poor effect.Lobal and isthmus resection was suitable for stage Ⅰ and Ⅱ patients,modified neck dissection should be done in stage Ⅲ patients.
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