甲状腺微小癌的诊断和治疗 杨征1 张斌2(通讯作者) 姜鹏2 郭慕红2.docVIP

精品论文 参考文献 甲状腺微小癌的诊断和治疗 杨征1 张斌2(通讯作者) 姜鹏2 郭慕红2 杨征1 张斌2(通讯作者) 姜鹏2 郭慕红2 　　(1 江苏省南京市江宁区第二人民医院外科 211103) 　　(2南京医科大学附属南京第一医院普外科 江苏南京 210006） 　　【摘要】目的:探讨甲状腺微小癌(TMC)的治疗方法。方法:对96例TMC患者的临床资料作回顾性分析。结果:本组96例中因甲状腺良性疾病手术而发现74例，超声检查发现91例(可疑)，超声引导下细胞学穿刺检查发现22例。行患侧甲状腺腺叶切除18例，腺叶切除+对侧次全切除24例，甲状腺次全切除12例，甲状腺大部切除10例，甲状腺癌改良根治术32例。90例随访1年～11年，未见肿瘤复发和转移。结论: TMC多因甲状腺良性疾病手术而发现，高分辨率彩色超声及B超引导下细针穿刺活检有助于本病的确诊。选择恰当的术式，既清除病灶又避免不必要的过度治疗。 　　【关键词】甲状腺肿瘤 甲状腺微小癌 外科手术 　　【中图分类号】R736.1 【文献标识码】A 【文章编号】2095-1752（2014）23-0075-02 　　Diagnosis and treatment of thyroid microcarcinoma 　　YANG Zheng，ZHANG Bin*，JIANG Peng，GUO Mu-hong 　　(Department of General Surgery ，Nanjing First Hospital Affiliated to NJMU，Nanjing 21000， China.) 　　【Abstract】 Objective: To investigate the diagnosis and treatment of thyroid microcarcinoma (TMC). Methods :The clinical data of 96 cases with TMC treated from Jan. 1997 to Dec. 2009 were retrospectively analyzed. Results: In 96 cases 74 were combined with other benign thyroid diseases. 91 cases were indicated as doubtful thyroid carcinoma by B ultrasonography. 22 cases were diagnosed by biopsy guided by ultrasonography. 18 cases of total lobectomy， Lobectomy of involved lobe with subtotalthyroidectomy of contra 2 lateral lobe was performed in 24 cases， 12 cases of subtotal thyroidectomy，10 cases of portion thyroidectomy，32 cases of improved radical operation of thyroid carcinoma. 90 patients were followed-up from 6 to 144 months， No recurrence or mortality was discovered. Conclusion :TMC combined common with other benign thyroid diseases.High-resolution color Doppler ultrasound and biopsy guided by ultrasonography help to diagnose TMC，and pertinent operation type can eliminate tumors and avoid unnecessary excesst reatment. 　　【Key words】thyroid neoplasm；thyroid microcarcinoma； surgical treatment 　　甲状腺肿瘤直径le;1cm为甲状腺微小癌(thyroid microcarcin oma，TMC)，TMC的组织学类型以乳头状癌为主，又称为甲状腺乳头状微小癌（papillary thyroid microcarcinoma，PTMC），少数是滤泡癌或髓样癌[1