甲状腺微小癌合并转移的诊治  

Diagnosis and treatment of occult thyroid cancer with metastasis

作　　者：胡作军[1] 王深明[1] 王燕华[1] 王琰[2] 陈国锐[1] 

机构地区：[1]中山医科大学附属第一医院外科,广东广州510080 [2]中山医科大学附属肿瘤医院CT室,广东广州510080

出　　处：《中国普通外科杂志》2003年第5期357-359,共3页China Journal of General Surgery

摘　　要：目的　探讨合并转移的甲状腺微小癌的诊断和治疗。方法　回顾性分析收治的 18例合并转移的甲状腺微小癌患者的临床资料。结果　 18例均采取手术治疗 ,术中及住院期间无死亡。 5例 ( 2 7.8% )术后转移 ,明显高于同期 10 0例无转移的甲状腺微小癌 ( 2 .0 % ,P <0 .0 0 1)。病理切片结果提示本组的癌灶均已穿透包膜 ,存在包膜外血管浸润。其中 7例因广泛转移于术后 5年内死亡。结论　应高度重视本病的危害性。甲状腺B超检查结合转移灶穿刺活检可提高本病诊断率。手术为首选的治疗方法。术后可辅以甲状腺素 ,1 31 I同位素等治疗。Objective To study the diagnosis and treatment of occult thyroid cancer with metastasis. Methods The clinical data of 18 cases of occult thyroid cancer with metastasis were analyzed retrospectively . Results All cases underwent operations. No death occurred during the operation and hospitalization .Postoperative metastasis occurred in 5 cases(27.8%). There was significant difference between the patients with metastasis and the other 100 patients without metastasis(P < 0.001) . Pathological study showed that all the tumors penetrated through the capsule and invaded to the extra capsular blood vessels .Seven cases died of wide metastasis five years after the operation . Conclusions A greater attention should be paid to this disease . Needle biopsy under the guide of ultrasonography on thyroid and metastasis focus is the key point of diagnosis . Operation is still the chief treatment. Thyroxine and radio isotope 131 I should be given after the operation .

关 键 词：甲状腺肿瘤/病理学 肿瘤转移 肿瘤浸润力 

分 类 号：R736.1[医药卫生—肿瘤] R73[医药卫生—临床医学]