甲状腺微小癌的诊断和治疗  

Diagnosis and treatment of thyroid microcarcinoma

作　　者：阎玉矿[1] 何美文[2] 高随宽[3] 曾惠峰[1] 李德宁[1] 彭海峰[1] 段君英[1] 

机构地区：[1]深圳市龙岗中心医院普外科,深圳518116 [2]北京大学深圳医院普外科,深圳518100 [3]北京大学第一医院普外科,北京100034

出　　处：《中国微创外科杂志》2003年第6期503-504,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨甲状腺微小癌的诊断和治疗。　方法　总结 1 993年 1 2月～ 2 0 0 2年 1月 5 3例术中及术后发现甲状腺癌的临床资料 ,其中甲状腺微小癌 4 2例。　结果　 5 3例中 2例合并对侧癌变 ,3例伴有颈淋巴结转移。术中冰冻切片诊断甲状腺癌 35例 ,术后病理证实甲状腺癌 1 8例。 35例行一侧腺叶全切除加峡部切除术 ,7例加颈淋巴结清扫术 ,其余行一侧腺叶全切除和一侧或两侧腺叶次全切除。随访 35例 ,时间 2月～ 96月 ,平均 4 6月 ,2例复发 ,无死亡。　结论　甲状腺微小癌术前诊断率较低。Objective To study the diagnosis and surgical treatment of thyroid microcarcinoma. Methods The authors reviewed 53 cases of thyroid cancer, which were diagnosed during and after surgery from December 1993 to January 2002,including 42 cases of thyroid microcarcinoma. Results Out of the 53 cases,35 cases were diagnosed during surgery by frozen section method while the other 18 cases were postoperatively diagnosed by pathological examinations;complicated carcinomatous conversion in contralateral lobe was found in 2 cases and neck lymphatic metastasis in 3 cases; lobectomy plus excision of isthmus was performed in 35 cases, 7 of which simultaneously underwent neck lymph node clearance,and unilateral lobectomy or unilateral or bilateral subtotal lobectomy was adopted in the remaining cases. Recurrence in 2 cases was found during a follow-up period for 2 months～96 months (mean,46 months) in 35 cases, and no fatal cases occurred. Conclusions A high rate of missed diagnosis of thyroid microcarcinoma is present. Thyroid microcarcinoma should be surgically removed.

关 键 词：甲状腺微小癌 淋巴结转移 诊断 治疗 

分 类 号：R736.1[医药卫生—肿瘤]