甲状腺癌的外科治疗
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范峻

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Surgical treatment of thyriod carcinoma
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    目的: 探讨甲状腺癌的外科手术治疗的方式和效果。方法:回顾性分析1990—2005年间上海市第八人民医院和江苏大学附属医院收治的126例甲状腺癌患者的临床资料。结果:126例甲状腺癌中,乳头状腺癌94例(74.6%),其中有2例为桥本氏病合并甲瘤和甲状腺乳头状腺癌,1例还合并有甲亢,滤泡状腺癌20例(15.9%),髓样癌5例(4.0%),未分化癌4例(3.2%),恶性淋巴瘤2例(1.6%),鳞状细胞癌1例。126例中肿瘤直径小于1cm的甲状腺微小癌(TMC)56例,均为乳头状腺癌。术后随访5年以上78例,1~5年36例,生活质量均为良好。未分化癌4例均于术后3~6个月死亡,2例髓样癌和1例鳞状细胞癌术后1年均因肺转移死于咯血。结论:早期诊断和治疗、规范手术切除范围可避免因漏诊再次手术,术后应早期尽量替代治疗。

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    Abstract:Objective:To summarize the methods and outcome of surgical treatment of thyriod carcinoma(TC). Methods:The clinical data of 126 cases of TC admitted between 1990 to 2005 to our 2 hospitals was analyzed. Results:Among the 126 cases, there were papillary carcinoma in 94 cases (74.5%),follicular carcinoma in 20 cases(15.9%), medullary carcinoma in 5 cases(4%), anaplastic carcinoma in 4 cases(3.2%), lymphoma in 2 cases(1.6%) and squamous cell carcinoma was in 1 case(0.8%). Thyroid microcarcinoma(TMC) was found in 56 of 126 cases and all of them were papillary carcinoma. Seventy-eight cases were followed up for more than 5 years after operation and 36 cases for 3 to 5 years, and all have good quality of life. All of the 4 cases with anaplastic carcinoma died in 3 to 6 months. Two cases with medullary carcinoma and 1 case with squamous cell carcinoma died from pulmonary metastases 1 year after operation. Conclusions:For differentiated TC, surgical treatment is the ideal treatment. However, for anaplastic TC, operation is not to be recommended, the choice of treatment is radiotherapy.

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范峻,朱彤,陈涛,姚昌宏.甲状腺癌的外科治疗[J].中国普通外科杂志,2006,15(4):10-273.
DOI:10.7659/j. issn.1005-6947.2006.04.010

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  • 在线发布日期: 2006-04-25