Diagnosis and Treatment of 178 Cases of Thyroid Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

张立阳 , 廖泉 , 赵玉沛

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Keywords：

甲状腺癌; 手术治疗

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【摘要】目的探讨甲状腺癌的诊断及治疗方法。
方法回顾性分析我院1999~2003年期间收治的178例行手术治疗的甲状腺癌患者的临床资料。
结果本组患者术前B超检查均发现甲状腺内实性或囊实性结节,其中结节内伴微钙化灶者50例（28.1%），B超检查对于颈部淋巴结转移的阳性预告值为78.1%。行术中冰冻切片检查162例，诊断甲状腺癌144例，阳性率为88.9%。术后病理检查证实有淋巴结转移者为34.3%（61/178），甲状腺癌局部或患侧叶切除术后行二次以上手术者30例，残癌率为43.3%（13/30）。
结论声音嘶哑及B超检查提示甲状腺结节内微钙化灶对甲状腺癌的术前诊断有重要提示意义，亦可作为是否行颈淋巴结清扫的指征之一。术中冰冻切片检查是确诊甲状腺癌的最佳方法。患叶+峡部+对侧大部切除是甲状腺癌的主要手术方式。

Citation： 张立阳,廖泉,赵玉沛. Diagnosis and Treatment of 178 Cases of Thyroid Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(6): 614-615. doi: Copy

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1. Liu S, Semenciw R, Ugnat AM, et al. Increasing thyroid cancer incidence in Canada, 1970-1996: time trends and ageperiodcohort effects [Ｊ]. Br J Cancer， 2001; 85(9)1335.
2. Kakkos SK, Scopa CD, Chalmoukis AK, et al. Relative risk of cancer in sonographically detected thyroid nodules with calcifications [Ｊ]. J Clin Ultrasound， 2000; 28(7)347.
3. From G, Mellemgaard A, Knudsen N, et al. Review of thyroid cancer cases among patients with previous benign thyroid disorders [Ｊ]. Thyroid， 2000; 10(8)697.
4. Cheng MS, Morgan JL, Serpell JW. Does frozen section have a role in the intraoperative management of thyroid nodules? [Ｊ]. ANZ J Surg， 2002; 72(8)570.
5. 徐伟，唐予章，李正江. 甲状腺癌局部切除术后再手术的探讨 [Ｊ]. 中华肿瘤杂志， 2002； 24（2）185.
6. Alvarez JC, Mendez JC, Moris C. Thyroid cancer treatment [Ｊ]. Ann Otolaryngol Chir Cervicofac， 2000; 117(1)40.
7. Klofanda J, Krska Z, Trca S. Total tyroidectomy in malignant goiter, significance and problems [Ｊ]. Rozhl Chir， 2002; 81(1)5.
8. Catarci M, Zaraca F, Angeloni R, et al. Preoperative lymphoscintigraphy and sentinel lymph node biopsy in papillary thyroid cancer. A pilot study [Ｊ]. J Surg Oncol, 2001; 77(1)21.
9. Kobayashi S. Appropriate extent of lymph node dissection in thyroid cancer [Ｊ]. Nippon Geka Gakkai Zasshi, 2001; 102(6)459.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of 178 Cases of Thyroid Cancer

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