甲状腺癌术前辅助检查对于病理分型和术式的选择意义_医学论文.docVIP

甲状腺癌术前辅助检查对于病理分型和术式的选择意义_医学论文 甲状腺癌术前辅助检查对于病理分型和术式的选择意义_医学论文 作者：凌瑞，李南林，张震，王岭，杨华 【关键词】 ,甲状腺肿瘤/病理学 　　【Abstract】 AIM: To assess the pathology type of thyroid nodules on the basis of clinical manifestation and other parameters of preoperative examination and to investigate its relationship with operation mode. METHODS: Using paraffin embedded tissue sections as the gold standard of diagnosing thyroid carcinoma, we divided 483 cases into four groups: group Ⅰ was papillary thyroid carcinoma, group Ⅱ was follicular thyroid carcinoma, group Ⅲ was undifferentiated carcinoma and group Ⅳ was medullary carcinoma. Ultrasonographic scanning was used to analyze the clinical manifestations and the relationship between the clinical manifestations and pathology type was assessed. RESULTS: Of the 483 cases, the 4 groups accounted for 68.1%, 23.4%, 2.9% and 5.6%, respectively. There was no significantly statistical correlation between the age and malignancy of the thyroid nodules between group Ⅰ, group Ⅱ and group Ⅳ, but there was significantly statistical correlation between group Ⅰ, group Ⅱ, group Ⅳ and group Ⅲ. The same was true of the diameter of the nodules. The cases with diameter gt4 cm were more likely to have undifferentiated carcinoma. There was no significantly statistical correlation between group Ⅰ, Ⅱ, Ⅲ and Ⅳ group for the number of nodules, but significantly statistical correlation was found between group Ⅰ/Ⅱ and group Ⅲ /Ⅳ in cold nodules and the intumescence of lymph node in the neck. The examination of thyroid function was not very helpful in the pathological classification of thyroid cancer. CONCLUSION: Preoperative examination is important in determining the pathological type and choosing proper surgical mode. 　　【Keywords】 Thyroid neoplasms/pathology biopsy, needle thyroid neoplasms/surgery 　　【摘要】 目的： 探讨甲状腺结节的临床特征，结合术前辅助检查对判断甲状腺恶性肿瘤病理分型的作用，并根据病理分型采取适当的手术方式. 方法： 以术后石蜡病理切片结果作为确诊甲状腺癌的金标准，将483例甲状腺癌患者分为4组，分别为乳头状腺癌（Ⅰ组）、滤泡状腺癌（Ⅱ组）、未分化癌（Ⅲ组）和甲状腺髓样癌（Ⅳ组），对各组的临床特征、甲状腺核素扫描、甲状腺