【摘要】 目的 探讨分化性甲状腺微灶癌的临床诊断及治疗。方法 对34例分化性甲状腺微灶癌及同期手术的37例分化性甲状腺非微灶癌的临床资料进行回顾性分析。结果 分化性甲状腺微灶癌(乳头状癌33例，滤泡状癌1例)健康体检发现率52.1%(18/34)，术前确诊4例，术前疑癌17例，术中快速冰冻病检确诊24例，术后确诊6例，行单侧腺叶或单侧腺叶+峡部切除14例，甲状腺次全切除11例，甲状腺全切1例，合并中央区或颈部淋巴结清扫8例。淋巴结转移率17.6%(6/34)。随访无肿瘤复发，无颈淋巴结转移和远处转移，无死亡。分化性甲状腺非微灶癌组健康体检发现率24.3%(9/37)，行单侧腺叶或单侧腺叶+峡部切除7例，甲状腺次全切除3例，甲状腺全切1例，甲状腺次全切除合并中央区或颈部淋巴结清扫26例，淋巴结转移率40.5%(15/37)，颈淋巴结复发1例，死亡1例。结论 (1)每年健康体检结合B超、同位素、CT、FNAB的运用有助于早期诊断;(2)本病临床进展缓慢，预后较好。但单发癌灶淋巴结转移率高。治疗建议选择单侧腺叶切除或甲状腺次全切除+术中活检快速冰冻病理检查。

    关键词 甲状腺肿瘤 微灶癌 诊断 甲状腺切除

    Well differentiated thyroid microcarcinoma

    Zong Bing，Zhu Jiangfan，Yu Ji anping，et al.

    Department of General

    Surgery，Jinshan Hospital，Fudan University，Shanghai200540.

    【Abstract】 Objective To investigate the diagnosis and treatment of well differentiated thyroid microcarcinoma(WDTMC).Methods Clinical data of34cases of WDTMC and37cases of well differentiated throid carcinoma(WDTC)were restrospecti vely reviewed.Results There were14men and20women within age of24-62years old in WDTMC consisting of33papillary and1follicular microcarcinomas.There were4men and33women within age of16-69years old in WDTC consisting of35papillary and2follicular carcinoma.Thyroid nodules had been found by annual check-up in18(52.1%)pati ents in WDTMC ......