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目的 :探讨隐匿甲状腺癌的诊断与治疗。方法 :对 34例隐匿性甲状腺癌的临床资料进行分析。结果 :仅有 6例术前诊断隐匿性甲状腺癌。 1 6例行患侧腺叶及峡部切除术 ,1 4例加颈淋巴结清扫术 ,1 8例行双侧腺叶次全切除术。病理见 34例癌灶均位于单侧腺叶 ,有颈淋巴结转移者 4例 ,其中 3例癌灶已穿透甲状腺被膜。癌灶内及其周围的甲状腺组织内查见砂粒体者 1 5例。随访 6个月～ 2 0年 ,1例死于肺转移 ,2例死于其他疾病 ,余均健在。结论 :1甲状腺手术时应警惕并存隐性癌的可能性 ;2甲状腺组织内查到砂粒体 ,则为癌存在的信息 ;3治疗应选择一侧腺叶全切或次全切除术。癌灶已穿透甲状腺被膜者或已有颈淋巴结转移者 ,应行颈淋巴结清扫术。
Objective: To investigate the diagnosis and treatment of latent thyroid cancer. Methods: The clinical data of 34 cases of occult thyroid cancer were analyzed. Results: Only 6 cases of occult thyroid cancer were diagnosed preoperatively. 16 cases of ipsilateral ipsilateral lobectomy and isthmus, 14 cases of cervical lymph node dissection, 18 cases of bilateral subtotal lobectomy. 34 cases of pathological lesions were located in the unilateral lobes of cancer, cervical lymph node metastasis in 4 cases, of which 3 cases of cancer lesions have penetrated the thyroid capsule. Fifteen cases were found in the thyroid gland in and around the foci. All cases were followed up for 6 months to 20 years. One died of lung metastases and 2 died of other diseases. Conclusions: 1 Thyroid surgery should be kept in mind the possibility of occult cancer; 2 sand body was found in thyroid tissue, the existence of cancer information; 3 treatment should choose one side of the lobectomy or subtotal resection. The foci have penetrated the thyroid capsule or have had cervical lymph node metastasis, cervical lymph node dissection should be performed.