|本期目录/Table of Contents|

[1]谷 寅,何向辉,赵 科. 结节性甲状腺肿合并偶发乳头状癌临床分析[J].天津医科大学学报,2015,21(03):245-247.
 GU Yin,HE Xiang-Hui,ZHAO Ke.Incidental papillary carcinoma in nodular goiter[J].Journal of Tianjin Medical University,2015,21(03):245-247.
点击复制

 结节性甲状腺肿合并偶发乳头状癌临床分析(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
21卷
期数:
2015年03期
页码:
245-247
栏目:
临床医学
出版日期:
2015-05-20

文章信息/Info

Title:
Incidental papillary carcinoma in nodular goiter
文章编号:
1006-8147(2015)03-0245-03
作者:
谷 寅何向辉赵  科
 
(天津医科大学总医院普通外科,天津 300052)
Author(s):
GU Yin; HE Xiang-Hui; ZHAO Ke
(Department of General Surgery ,General Hospital, Tianjin Medical University ,Tianjin 300052 ,China)
关键词:
结节性甲状腺肿甲状腺乳头状癌预后
Keywords:
 nodular goiter papillary thyroid carcinoma prognosis
分类号:
R736.1
DOI:
-
文献标志码:
A
摘要:
目的:总结结节性甲状腺肿合并偶发乳头状癌(IPC)的临床特点和治疗要点。方法:回顾性分析92例结节性甲状腺肿合并偶发乳头状癌患者的临床资料及病理特点。结果: 92例(7.2%)结节性甲状腺肿合并偶发乳头状癌患者,男性15例(17.4%),女性77例(82.6%),最大良性结节平均直径为(2.37±0.68)cm,单侧发病60例(65.2%),双侧发病32例(34.8%),偶发乳头状癌直径为0.1~1.0 cm,平均直径(0.43±0.27)cm,91例(98.9%)为单发癌灶,1例(1.1%)为单侧多发癌灶(2个),92例(100%)患者术后长期口服左甲状腺素片,80例(87%)得到随访,随访时间7~72月,未发现复发及淋巴结转移。结论:结节性甲状腺肿合并偶发乳头状癌发病率为7.2%,对术前诊断为结节性甲状腺肿患者,单侧发病实施腺叶切除,双侧发病实施腺叶+次全切除或近全切除术,术后诊断为偶发乳头状癌,一般预后良好,但应长期口服左甲状腺素片抑制治疗,定期随访。
Abstract:
Objective: To investigate the clinical features and principles for the diagnosis and treatment of incidental papillary carcinoma (IPC) in goiter. Methods: Ninety-two patients with different thyroid carcinoma in nodular goiter admitted from July 2008 to December 2013 were retrospectively analyzed. Results: Overall, Ninety-two IPCs were recorded (male 15,female 77). The largest benign nodules had an average diameter(2.37±0.68)cm , the diameter of IPC ranged from 0.1~1.0 cm and the average diameter was (0.43±0.27)cm. Ninety-one cases(98.9%) were unifocal, and 1 case was unilateral multifocal(2 centers), 92 cases(100%) took L-T4 post operation for long time, 80 cases were followed up for 7~72 months and no recurrence or metastasis was found. Conclusion: The overall incidence of IPC in nodular goiter was 7.2%. For IPC patients who are considered nodular goiter receiving lobectomy or near-total thyroidectomy before operation, reoperation is unnecessary. However, L-T4 is regular drug for post-operation patients. Regular following-up is also essential.

参考文献/References:

[1] Pearce E N, Braverman L E. Papillary thyroid microcarcinoma outcomes and implications for treatment[J]. J Clin Endocrinol Metab ,2004,89(9):3710

[2]郑泽霖, 孙辉, 盖宝东.甲状腺良性疾病并存甲状腺癌[J].中国普通外科杂志,2008,17(5):407

[3]Miccoli P , Minuto M N , Galleri D , et al. Incidental thyroid carcinoma in a largeseries of consecutive patients operated on for benign thyroiddisease[J].Aust N Z J Surg,2006,76(3):123

[4]Sakorafas G H , Stafyla V , Kolettis T , et al. Microscopic papillary thyroid Cancer as an incidentalfinding in patients treated surgically for presumably benign thyroid disease[J]. J Postgrad Med, 2007,53(1):23

[5]张惠灏, 陈祥锦.甲状腺乳头状微小癌108例诊治分析[J].中国社区医师:医学专业半月刊,2009,49(24):18

[6] 许振梅. 31例甲状腺微小乳头状癌的超声分析[J].山东医药,2009,49(46):51

[7]Rago T , Santini F , Scutari M , et al. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules[J].J Clin Endocrinol Metab,2007,92(8):2917

[8]American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer , Cooper D S , Doherty G M , et al.Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid Cancer[J].Thyroid,2009,19(11):1167

[9]Pelizzo M R, Boschin I M, Toniato A, et al. Papillary thyroidmicrocarcinoma(PTMC):prognostic factors,management and outcomein 403 patients[J].Eur J Surg Oncol,2006,32(10):1144

[10]裴雷,陈干农,周恩相,等.微小乳头状甲状腺癌行颈淋巴结清扫术的必要性探讨[J].中国普通外科杂志,2011,20(5):443

[11] 王秀玲, 陶琨, 徐杭蓓,等.甲状腺冰冻与石蜡切片的病理诊断[J].上海第二医科大学学报,2002,22(2):175

[12] Tezelman S , Borucu I , Senyurek Y , et al. Thechange in surgical practice from subtotal to near-total or totalthyroidectomy in the treatment of patients with benignmultinodular goiter[J]. World J Surg,2009,33(3):400

[13]丁雷,张焕虎,战志勇,等 .102例甲状腺微小癌诊治分析[J].中国现代普通外科进展,2010,13(9):740

相似文献/References:

[1]索晓鹏,何小玲,何向辉,等. 甲状腺乳头状癌滤泡亚型声像图及临床病理特征分析[J].天津医科大学学报,2015,21(02):154.
 SUO Xiao-peng,HE Xiao-ling,HE Xiang-hui,et al.Analysis of ultrasonography and clinical pathological characteristics of follicular variant of papillary thyroid carcinoma[J].Journal of Tianjin Medical University,2015,21(03):154.
[2]彭泽椿,郑向前,高 明.甲状腺乳头状癌临床病理学特征与肥胖的相关性研究[J].天津医科大学学报,2018,24(05):429.
 PENG Ze-chun,ZHENG Xiang-qian,GAO Ming.Correlation between body mass index and clinicopathological characteristics of papillary thyroid carcinoma[J].Journal of Tianjin Medical University,2018,24(03):429.
[3]闫云飞,刘娜,叶贝贝,等.喉前淋巴结与甲状腺乳头状癌颈部淋巴结转移的相关性研究[J].天津医科大学学报,2021,27(04):369.
 YAN Yun-fei,LIU Na,YE Bei-bei,et al.Correlation between delphian lymph node and cervical lymph node metastasis of papillary thyroid carcinoma[J].Journal of Tianjin Medical University,2021,27(03):369.
[4]高关清,郭丹,卢文亚,等.神经介素U蛋白在人甲状腺乳头状癌中表达的意义及作用机制[J].天津医科大学学报,2023,29(05):521.
 GAO Guan-qing,GUO Dan,LU Wen-ya,et al.The significance and mechanism of expression of neuromedin U protein in human papillary thyroid carcinoma[J].Journal of Tianjin Medical University,2023,29(03):521.

备注/Memo

备注/Memo:
作者简介 谷寅(1986-),男,硕士在读,研究方向:普通外科;

通信作者:何向辉,E-mail:humphreyhe@163.com

更新日期/Last Update: 2015-05-27