甲状腺髓样癌35例治疗体会.pdfVIP

438 Dec．2007．Vo1．11．No．6 · 临 床 论 著 · [文章编号]1009—2188(2007)06—0438—03 甲状腺髓样癌35例治疗体会 粱毅，朱琳，杨魁 (中南大学湘雅医学院第二临床学院，长沙410011) [摘要] 目的 总结甲状腺髓样癌(medullary thyroid carcinoma，MTC)临床特征及治疗方法。 方 法 回顾分析1997年1月～2005年12月经治的35例MTC的临床及病理资料。 结果 35例均予手 术切除原发灶并加行颈淋巴结清扫术，术后放疗5例，化疗7例。所有病例均经病理证实为MTC，淋巴 结转移率为51．4％。32例术后随访2—1O年，5年生存率为87．5％。 结论 MTC治疗应以根治性切 除为原则，切除范围应比其他类型的甲状腺癌积极，术后可以辅以多种非手术治疗。 [关键词] 甲状腺肿瘤 [中图分类号]R736．1 [文献标识码]B Experience in Treatment of 35 Cases Medullary Thyroid Carcinoma LIANG Yi，ZHU Lin YANG Kui ， (Second Xiangya Hospital，Central South University，Changsha 410011，Hunan，China) Abstract： Objective To discuss the clinical characteristics and treatment of medullary thyroid carcino． ma(MTC)． Method The clinical and pathological data of 35 cases of MTC was retrospectively analyzed． Results Total thyroidectomy and cervical lymph node dissection were performed in all the 35 cases．Radio． therapy in 5 cases and chemotherapy in 7 cases were adoptedafter operation．The lymph node metastasis rate was 51．4％．In 32 cases who were followed up for 2 to 10 years．the 5-year survivaI rate was 87．5％． Con． clusion Surgery iS considered as the only satisfactory treatment for MTC．Dissection area should be more radi． eal compared with other thyroid carcinoma．Nonsurgical therapies，such as radiotherapy and chemotherapy， would be adopted after the operation． Key words： thyroid neoplasms 甲状腺髓样癌(medullary thyroid carcinoma， (19～53)岁。病人均因颈部包块前来就诊，肿块平 MTC)又称为甲状腺滤泡旁细胞癌或c细胞癌，约占 均直径3、2(0．8～6)am。单侧14例，双侧21例。 甲状腺肿瘤的5％～10％，属具有摄取胺前体及脱羧 伴同侧颈部淋巴结肿大II例，伴双侧颈部淋巴结肿 功能(amine precursor uptake and decarboxylation， 大3例，伴慢性腹泻2例，面部潮红3例，呼吸困难 APUD)系统肿瘤…，发病率男女相当，以女性略多。 2例，伴声嘶I例。病程平均3．7年(4周～1O年)， MTC分为散发型和家族型两