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.doc

甲状腺微小癌的诊断和治疗杨征1张斌2（通讯 ）姜鹏2郭慕红2 杨征1张斌2（通讯 ）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） 】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例屮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），超声引导不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 】R736.1 】A 】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. Keywords】 thyroid neoplasm； thyroid microcarcinoma; surgical treatment 甲状腺肿瘤直径le;lcm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, 2］，其起病隐匿， 检查时难以扪及，常与甲状腺其他疾病并存。近年来，随着高分辨率彩色超声的 应用，越来越多的甲状腺内微小结节被检查出。1997年1月?2009年12月，本 院共收治TMC患者96例。现将苏临床