47例甲状腺微小癌诊治分析.docVIP

47例甲状腺微小癌诊治分析 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：47例甲状腺微小癌诊治分析 1 1资料与方法 2 32诊断 4 33治疗 5 文2：甲状腺微小癌32例诊治分析 5 1 资料与方法 6 2 结果 7 3 讨论 7 参考文摘引言： 10 原创性声明（模板） 11 文章致谢（模板） 12 正文 47例甲状腺微小癌诊治分析 文1：47例甲状腺微小癌诊治分析 【ABSTRACT】Objective: To summarize clinical diagnosis for thyroid minimal cancer and its therapeutic experience. Methods: Retrospectively analyse 47 cases with thyroid minimal cancer that are diagnosed definitely. Results: In the 47 cases with thyroid minimal cancer, only 12 cases is suspect to have thyroid cancer before operation,the rest 35 cases are diagnosed definitely during the operation and postoperative pathologic diagnosis. 34 cases have complication of it nomalignancy,and 3 cases were accompanied by cervical part lymph nod metastasis. Among 47 cases, noneoplasia survival time is for 11 cases ≥10 yea after operation and that of 24 cases is ≥5 yea. Conclusion: Thyroid minimal cancer is not diagnosed easily and sometimes thyroid nomalignancy diseases, palpatio should be used carefully during the operation and ultra cryotomy should be made to the suspected nod. The fittime operation should be on the side of gland and pharyx ectomy,and for patients with lymph nod matastasis cervical lymph nod clearance operation should be done. Thereby better effects can be gained. The routing cerrical lymph nod clearance operation seems uncessany. 【KEY WORDS】Thyroid minimal cancer; Missed diagnosis; B ultrasonic examination; Diagnosis; Therapeutic 甲状腺微小癌(thyroid microcarcinoma,TMC)指肿瘤直径≤10cm、术前很难发现或不易诊断的甲状腺原发癌，是甲状腺乳头状腺癌的一种临床亚型。现 总结 回顾 中国 人民解放军总 医院 自1993~2003年收治的甲状腺微小癌47例，报告如下。 1资料与方法 11一般资料47例患者中，男8例（17％），女39例（83％）；年龄28～63岁，平均437岁；病程1月～19年；41例以颈部结节就诊，2例疑为甲亢就诊；临床检查3例有颈部淋巴结肿大。术前均经B超检查，均为实性结节，其中低回声结节26例，无包膜19例，有细小钙化疑为癌12例。术前诊断：疑为甲状腺癌12例，甲状腺瘤19例，结节性甲状腺肿14例，甲亢2例。全部手术治疗，行单侧腺叶切除8例，一侧腺叶及峡部切除28例（其中有3例首次术中未确认而又行二次手术），两侧腺叶次全切除11例，3例行一侧腺叶、峡部切除及功能性颈淋巴结清扫术。 12方法47例中34例（72％）合并甲状腺良性疾病，其中合并甲状腺腺瘤21例（45％），结节性甲状腺肿9例（19％），甲亢2例（4％），桥本氏病2例（4％），颈淋巴结转移3例（6％）。原发灶直径04