摘要
目的探讨甲状腺微小癌临床病理特征、手术方式与其预后的关系。方法对45例经临床病理检查确诊为甲状腺微小癌患者的临床病理特征、手术方式进行总结,并对预后进行随访。结果 45例患者的病理组织学类型均为乳头状癌,其中8例为双侧多灶癌。45例患者中,患侧全切+对侧次全切38例,双侧次全切2例,患侧全切+峡部切除1例,患侧次全切+峡部+对侧部分切除2例,患侧次全切2例,其中17例行一期颈部淋巴结清扫,均未见淋巴结内癌转移。术后随访6～77个月,均未见复发及转移。结论甲状腺微小癌预后较好,淋巴结转移率低,其较为恰当的手术方式为双侧甲状腺次全切除术或患侧腺叶全切+峡部+对侧次全切除术,一般不作预防性颈淋巴结清扫术。
Objective To study the association of clinicopathological characteristics and surgical procedure with the prognosis of thyroid microcarcinoma.MethodsPatients with clinicopathologically diagnosed thyroid microcarcinoma（n=45） were enrolled for the analysis of clinicopathological characteristics and surgical procedure.Patients were followed up for the evaluation of prognosis.ResultsThe pathological type of thyroid microcarcinoma in 45 patients was papillary carcinoma,including bilateral multifocal carcinoma（n=8）.Among 45 patients,38 underwent total resection of the affected lobe plus subtotal resection of the contralateral lobe,two underwent bilateral total resection,one underwent total resection of the affected lobe and isthmus lobectomy,two underwent total resection of the affected lobe plus isthmus lobectomy and partial resection of the contralateral lobe,and subtotal resection of the affected lobe.Seventeen patients underwent synchronous cervical lymph node dissection whereas no lymph node metastasis was detected.Patients were followed up for 6～77 mo,showing no recurrence or metastasis.ConclusionThyroid microcarcinoma has a favorable prognosis and a low rate of lymph node metastasis.The preferred procedure should be bilateral total resection or total resection of the affected lobe plus isthmus and contralateral lobectomy.Prophylactic cervical lymph node dissection is performed as routine.
出处
《医学综述》
2011年第6期956-958,共3页
Medical Recapitulate
关键词
甲状腺微小癌
临床病理特征
手术方式
淋巴结转移
预后
Thyroid microcarcinoma
Clinicopathological characteristics
Surgical procedure
Lymph node metastasis
Prognosis
