• 中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院基本外科（北京 100730）;

【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(shù)治療的甲狀腺癌患者的臨床資料。
結(jié)果 本組患者術(shù)前B超檢查均發(fā)現(xiàn)甲狀腺內(nèi)實性或囊實性結(jié)節(jié),其中結(jié)節(jié)內(nèi)伴微鈣化灶者50例（28.1%），B超檢查對于頸部淋巴結(jié)轉(zhuǎn)移的陽性預(yù)告值為78.1%。行術(shù)中冰凍切片檢查162例，診斷甲狀腺癌144例，陽性率為88.9%。術(shù)后病理檢查證實有淋巴結(jié)轉(zhuǎn)移者為34.3%（61/178），甲狀腺癌局部或患側(cè)葉切除術(shù)后行二次以上手術(shù)者30例，殘癌率為43.3%（13/30）。
結(jié)論 聲音嘶啞及B超檢查提示甲狀腺結(jié)節(jié)內(nèi)微鈣化灶對甲狀腺癌的術(shù)前診斷有重要提示意義，亦可作為是否行頸淋巴結(jié)清掃的指征之一。術(shù)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(cè)大部切除是甲狀腺癌的主要手術(shù)方式。

引用本文： 張立陽,廖泉,趙玉沛. 178例甲狀腺癌診治體會. 中國普外基礎(chǔ)與臨床雜志, 2005, 12(6): 614-615. doi: 復(fù)制

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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(shù)后再手術(shù)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.
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  2. 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. 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. 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. 5. 徐偉，唐予章，李正江. 甲狀腺癌局部切除術(shù)后再手術(shù)的探討 [Ｊ]. 中華腫瘤雜志， 2002； 24（2）185.
  6. 6. Alvarez JC, Mendez JC, Moris C. Thyroid cancer treatment [Ｊ]. Ann Otolaryngol Chir Cervicofac， 2000; 117(1)40.
  7. 7. Klofanda J, Krska Z, Trca S. Total tyroidectomy in malignant goiter, significance and problems [Ｊ]. Rozhl Chir， 2002; 81(1)5.
  8. 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. 9. Kobayashi S. Appropriate extent of lymph node dissection in thyroid cancer [Ｊ]. Nippon Geka Gakkai Zasshi, 2001; 102(6)459.