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对61 例手术并经病理证实的隐惹性甲状腺癌的临床资料进行分析,以探讨隐惹性甲状腺癌的诊断和治疗特点。其中因甲状腺其他疾病术后病理检查时发现23 例( 占377 % ) ,以颈淋巴结转移为首发症状者34 例( 占557 % ) ,以远处转移为首发症状者2 例,其他部位手术发现2 例。全部病例均行手术治疗。颈淋巴结转移率为623 % 。10 年生存率为875 % 。若临床触及甲状腺内坚硬小结节或术中发现腺体内有质硬灰白结节,应高度怀疑本病可能,术中可做冰冻切片来明确诊断。伴有肿大淋巴结,活检或针吸细胞学检查有助于诊断。对有颈淋巴结转移者应行甲状腺癌联合根治术。单纯甲状腺肿物者应行腺叶加峡部切除术,依据术后病理情况决定是否行预防性颈清术。
The clinical data of 61 cases of cryptogenic thyroid cancer confirmed by pathology were analyzed to investigate the diagnosis and treatment characteristics of thyroid cancer. Among them, 23 cases (37.7%) were found after pathological examination of other thyroid diseases, 34 cases (55.7%) had neck lymph node metastasis as the first symptom, and 2 cases had distant metastasis as the first symptom. 2 cases were found in other sites. All cases were treated with surgery. The rate of cervical lymph node metastasis was 623%. The 10-year survival rate was 87.5%. If the clinical contact with hard nodules in the thyroid gland or found in the surgery gland hard gray tubercle, should be highly suspected of the disease may be frozen in the surgery to make a clear diagnosis. With enlarged lymph nodes, biopsy or needle aspiration cytology can help diagnose. For patients with cervical lymph node metastasis, thyroid cancer should be combined with radical surgery. Patients with simple thyroid tumors should be performed plus gland isthmic resection, according to the pathological conditions after surgery to determine whether the preventive neck dissection.