【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。
Objective To analyze and summarize clinical characteristics, diagnostic method, choice of treatment, and prognosis of metastatic lung cancer to thyroid gland. Method The clinical materials of the 15 patients presenting with secondary thyroid cancer were analyzed retrospectively. Results There were 10 females and 5 males in the 15 patients, with the female to male ratio of 2 : 1. The age ranged from 36 to 79 years old with an average 59 years old. The diagnoses of 12 cases were made by the surgery or the fine needle aspiration biopsy (FNAB), 3 cases by the clinic. The interval from the diagnosis of the primary tumor to the thyroid metastasis varied from 0 month to 21 months with an average 4 months. Three patients received the thyroidectomy, 5 patients received the chemotherapy or chemoradiotherapy, and 7 patients gave up the treatment. The average survival time was 10 months. Conclusions Metastatic lung cancer to thyroid gland is rare, and FNAB is a useful tool for diagnosis. Thyroidectomy may not be recommended because of poor prognosis.
目的 总结胰腺实性假乳头状瘤再次手术病例的诊断和治疗经验。方法 回顾性分析2002年12月至2011年12月期间笔者所在医院收治的4例胰腺实性假乳头状瘤再次手术患者的临床资料。结果 4例患者均行手术治疗，术后恢复良好，随访时间3个月～8年，平均47个月。至2012年3月，3例患者分别无瘤生存3个月、3个月以及8年；1例患者于术后8年死于营养吸收障碍，死亡时无肿瘤复发。结论 胰腺实性假乳头状瘤具有低度恶性倾向，以局部复发为主，远处转移少见。手术是复发、转移病例的最佳选择，具有较好疗效。
【Abstract】ObjectiveTo establish adriamycin (ADM) resistant pancreatic cancer cell line SW1990/ADM and to investigate its drug resistance mechanism.MethodsADM-resistant pancreatic cancer cell line SW1990/ADM was obtained by culture of pancreatic cancer cell line SW1990 in vitro with intermittently increasing the concentration of ADM in the culture medium for ten months. After two months of drug free culture, its biological characteristics, drug sensitivity as well as the expression and function of multidrug resistant gene 1 (mdr1) were detected, respectively. ResultsCompared with the parental cell line, SW1990/ADM showed great changes in biological characteristics and developed a cross resistance to various chemotherapy drugs. The drug resistance indexes of cell line SW1990/ADM to ADM, mitomycin, fluorouracil and gemcitabine were 49.60, 7.25, 3.80 and 1.25, respectively. The level of mdr1 mRNA expression in cell line SW1990/ADM was much higher than that of the parental cell line（P＜0.01). ConclusionWe have established adriamycin resistant pancreatic cancer cell line SW1990/ADM with multidrug resistance phenotype, its multidrug resistance is positively relevant to the expression of mdr1.