中国实用外科杂志

中国实用外科杂志

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双侧甲状腺癌的临床新特点

陈振宇，吴    毅   

  1. 复旦大学附属肿瘤医院头颈外科  复旦大学上海医学院肿瘤学系，上海200032
  • 发布日期:2011-12-29

  • Published:2011-12-29

摘要：

目的    探讨双侧甲状腺癌的临床新特点。方法    回顾性分析比较复旦大学肿瘤医院头颈外科1999年和2009年双侧甲状腺癌的临床资料，以及1999年和2009年初治的同时发生的双侧甲状腺癌的临床病理资料。结果    1999年收治双侧甲状腺癌26例，包括同时发生的双侧甲状腺癌16例，先后发生的甲状腺癌病例10例；2009年收治双侧甲状腺癌130例，包括同时发生的双侧甲状腺癌104例，先后发生的双侧甲状腺癌病例26例。1999年16例同时发生的双侧甲状腺癌病例中，双侧微小癌2例（12.5%），单侧微小癌5例（31.2%）；2009年104例同时发生的双侧甲状腺癌病例中，双侧微小癌28例（26.9%），单侧微小癌80例（77%）。2009年104例同时发生的双侧甲状腺癌中，中央区淋巴结转移率达70%，无中央区淋巴结转移病例颈侧区转移率为13.3%， 而有中央区转移的病例颈侧区转移率达56%。结论    2009年资料与1999年资料相比，双侧甲状腺癌构成比和微小癌比例差异显著， B超的广泛应用和准确度提高可能是造成这种变化的原因。双侧甲状腺癌应该常规作中央区淋巴结清扫，并且仔细探查有无颈侧区转移。

关键词: 双侧甲状腺癌, 淋巴结转移

Abstract:

New clinical characteristics of bilateral thyroid cancer        CHEN Zhen-yu, WU Yi. Department of  Head and Neck Surgery, Cancer Hospital, FuDan University, Shanghai 200032, China
Corresponding author: WU Yi, E-mail: ywu@rddb . shanghai.gov.cn
Abstract    Objective    To discuss the new clinical characteristics of bilateral thyroid cancer. Methods    Clinical data of 26 cases of bilateral thyroid cancers from the year of 1999 were compared retrospective with 130 cases of their counterparts from the year of 2009 and so it was with the clinic-pathologic data of 16 cases from the year of 1999 and 104 cases from the year of 2009. Results    There were 26 cases of bilateral thyroid cancers  including 16 cases of synchronous bilateral thyroid cancers  and 10 cases of metachronous bilateral thyroid cancers  from the year of 1999 ; There were 130 cases of  bilateral thyroid cancers including 104 cases of synchronous bilateral thyroid cancers  and 26 cases of metachronous bilateral thyroid cancers  from the year of 2009. There were 2 cases of bilateral micro-carcinoma (12.5%)  and 5 cases of mono-lateral micro-carcinoma（31.2%） in the group of synchronous bilateral thyroid cancers in 1999; There were 28 cases of bilateral micro-carcinoma (26.9%)  and 80 cases of mono-lateral micro-carcinoma（77%）in its counterpart in 2009. In the group of 104 synchronous bilateral thyroid cancers in 2009, central neck lymph node metastases occur in 70% cases, percentage of lateral neck involvement was 13.3% in cases with negative central neck and 56% in cases with involved central neck. Conclusion    The constituent ratio of bilateral thyroid cancers had changed in the year of 2009 compared with that of 1999 which might be due to the general application of ultrasound and its improved accuracy. Routine central node dissection should be carried out and lateral neck should be carefully checked.

Key words: bilateral thyroid cancers , lymph node metastasis