Diagnosis and Treatment of 178 Cases of Thyroid Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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張立陽 , 廖泉 , 趙玉沛

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Keywords：

甲狀腺癌; 手術治療

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【摘要】目的探討甲狀腺癌的診斷及治療方法。
方法回顧性分析我院1999~2003年期間收治的178例行手術治療的甲狀腺癌患者的臨床資料。
結果本組患者術前B超檢查均發現甲狀腺內實性或囊實性結節,其中結節內伴微鈣化灶者50例（28.1%），B超檢查對于頸部淋巴結轉移的陽性預告值為78.1%。行術中冰凍切片檢查162例，診斷甲狀腺癌144例，陽性率為88.9%。術后病理檢查證實有淋巴結轉移者為34.3%（61/178），甲狀腺癌局部或患側葉切除術后行二次以上手術者30例，殘癌率為43.3%（13/30）。
結論聲音嘶啞及B超檢查提示甲狀腺結節內微鈣化灶對甲狀腺癌的術前診斷有重要提示意義，亦可作為是否行頸淋巴結清掃的指征之一。術中冰凍切片檢查是確診甲狀腺癌的最佳方法。患葉+峽部+對側大部切除是甲狀腺癌的主要手術方式。

Citation： 張立陽,廖泉,趙玉沛. Diagnosis and Treatment of 178 Cases of Thyroid Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(6): 614-615. doi: Copy

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1. Liu S, Semenciw R, Ugnat AM, et al. Increasing thyroid cancer incidence in Canada, 1970-1996: time trends and ageperiodcohort effects [Ｊ]. Br J Cancer， 2001; 85(9)1335.
2. Kakkos SK, Scopa CD, Chalmoukis AK, et al. Relative risk of cancer in sonographically detected thyroid nodules with calcifications [Ｊ]. J Clin Ultrasound， 2000; 28(7)347.
3. From G, Mellemgaard A, Knudsen N, et al. Review of thyroid cancer cases among patients with previous benign thyroid disorders [Ｊ]. Thyroid， 2000; 10(8)697.
4. Cheng MS, Morgan JL, Serpell JW. Does frozen section have a role in the intraoperative management of thyroid nodules? [Ｊ]. ANZ J Surg， 2002; 72(8)570.
5. 徐偉，唐予章，李正江. 甲狀腺癌局部切除術后再手術的探討 [Ｊ]. 中華腫瘤雜志， 2002； 24（2）185.
6. Alvarez JC, Mendez JC, Moris C. Thyroid cancer treatment [Ｊ]. Ann Otolaryngol Chir Cervicofac， 2000; 117(1)40.
7. Klofanda J, Krska Z, Trca S. Total tyroidectomy in malignant goiter, significance and problems [Ｊ]. Rozhl Chir， 2002; 81(1)5.
8. Catarci M, Zaraca F, Angeloni R, et al. Preoperative lymphoscintigraphy and sentinel lymph node biopsy in papillary thyroid cancer. A pilot study [Ｊ]. J Surg Oncol, 2001; 77(1)21.
9. Kobayashi S. Appropriate extent of lymph node dissection in thyroid cancer [Ｊ]. Nippon Geka Gakkai Zasshi, 2001; 102(6)459.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of 178 Cases of Thyroid Cancer

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