甲状腺癌局部切除术后残癌率的临床分析和意义
作者:
通讯作者:
作者单位:

作者简介:

章佳新

基金项目:


Clinical analysis and significance of residual tumor rate after local resection of thyroid carcinoma
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 音频文件
  • |
  • 视频文件
    摘要:

    目的:探讨甲状腺癌行局部切除术后残癌率的评估,为临床制定再手术的适应证提供理论依据。
    方法:回顾性分析56例在行甲状腺癌局部切除术后,行再次手术治疗患者的临床资料。
    结果:病理证实再手术患者残癌率为42.8%;首次手术前肿瘤直径大于4 cm者残癌率为80.0%;肿瘤小于2 cm者为11.1%;单发结节残癌率为27.5%,多发结节为81.3%;肿瘤侵及甲状腺被膜者残癌率为86.3%,未侵及被膜者为14.7%;首次手术行结节切除术者残癌率为47.6%,行患侧腺叶部分切除者残癌率50.0 %,行腺叶次全切除术者为12.5%。再手术前CT和彩色多普勒检查发现癌残留的灵敏度分别为64.0%和60.0%,阳性预测值分别为80.0%和75.0%。
    结论:甲状腺癌局部切除术残癌率较高,再手术是必要的,首次手术前肿瘤情况和CT扫描对筛选再手术患者有首要意义,按适应证选择手术病例,可以使不必要再手术的患者免受手术之苦。

    Abstract:

    Abstract:Objective:To evaluate the rate of residual tumor after local resection of thyroid carcinoma, and provide theoretical basis to determine the indications for re-operation.
    Methods :The clinical data of 56 patients, who had re-operation in our hospital after local resection of thyroid carcinoma, were summarized.
    Results:As confirmed by pathology, the rate of residual tumor of patients was 42.8% at re-operation. When the tumor was larger than 4 cm, or smaller than 2 cm before the first operation, the residual tumor rate was 80% and 11.1% respectively. The residual tumor rate was 86.3% in patients with tumor invading thyroid capsule, 14.7% in patients without capsule invasion, 47.6% in patients who had only nodule resection, 50% after ipsi-lateral partial lobectomy, and 12.5% after subtotal thyroidectomy. The sensitivity of finding residual tumor by CT and doppler ultrasound examiination before re-operation was 64.0% and 60.0% respectively, and the positive predictive value was 80.0% and 30.0% respectively.
    Conclusions:The rate of residual tumor is high in patients with thyroid cancer operated by local resection. And it′s necessary to re-operation. The condition of tumor before the first operation and CT examination are significant for selection of patients to have re-operation.

    参考文献
    相似文献
    引证文献
引用本文

章佳新, 祝玉祥, 邵稳喜.甲状腺癌局部切除术后残癌率的临床分析和意义[J].中国普通外科杂志,2008,17(5):3-414.
DOI:10.7659/j. issn.1005-6947.2008.05.003

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2008-05-25