CAJ | 학술논문

目的总结家族性甲状腺乳头状微小癌(PTMC)的临床特征和诊治方法.方法分析2004年10月至2005年1月经手术和病理检查证实的家族性PTMC 8例患者的临床资料.结果随访率为100%,随访时间9～13个月,平均10.8个月.无复发及死亡病例,未发现远处转移.8例患者中发生颈部淋巴结转移2例,其中可触及肿大淋巴结且病理证实为癌转移1例,未触及肿大淋巴结但病理证实为癌转移1例,均转移至同侧,均发生在颈深上组淋巴结.腺叶多发结节2例均发生颈部淋巴结转移,单发结节6例未发生颈部淋巴结转移.合并结节性甲状腺肿2例;合并慢性淋巴细胞性甲状腺炎1例.结论 PTMC多数在良性结节术中或术后病理检查发现,家族性发病罕见.术前触诊、彩色多普勒超声检查、术中探查及冰冻切片对提高PTMC的诊断非常重要.对甲状腺肿瘤高发区患者的亲属进行筛查有助于早期发现肿瘤.患侧腺叶切除术作为常规术式以避免二次手术.应根据PTMC的临床特征,选择不同术式.
목적 총결가족성갑상선유두상미소암(PTMC)적림상특정화진치방법.방법 분석2004년10월지2005년1월경수술화병리검사증실적가족성PTMC 8례환자적림상자료.결과 수방솔위100%,수방시간9～13개월,평균10.8개월.무복발급사망병례,미발현원처전이.8례환자중발생경부림파결전이2례,기중가촉급종대림파결차병리증실위암전이1례,미촉급종대림파결단병리증실위암전이1례,균전이지동측,균발생재경심상조림파결.선협다발결절2례균발생경부림파결전이,단발결절6례미발생경부림파결전이.합병결절성갑상선종2례;합병만성림파세포성갑상선염1례.결론 PTMC다수재량성결절술중혹술후병리검사발현,가족성발병한견.술전촉진、채색다보륵초성검사、술중탐사급빙동절편대제고PTMC적진단비상중요.대갑상선종류고발구환자적친속진행사사유조우조기발현종류.환측선협절제술작위상규술식이피면이차수술.응근거PTMC적림상특정,선택불동술식.
Objective To summarize the clinical characteristics.diagnosis and treatment of familial papillary thyroid microcarcinoma(PTMC).Method The clinical data of 8 cases of familial PTMC admitted from October 2004 to January 2005 were analyzed.Results All patients were followed-up during 9 to 13(mean 10.8)months. No one suffered recurrence and dead. PTMC was found in 2 cases incidentally from thyroid specimens removed for supposed benign disease, another 6 cases were doubtful of cancer before operation and were identified by frozen section.Upper deep cervical lymph nodes were involved in 2 eases with lymph node metastasis. Lymph node metastasis in eases of multifoeal cancer in the affected lobe or of both lobe was significantly higher than those in monofoccal cancer in uni-lobe. Conclusions Most of the PTMC are found among the benign nodules during operation or within the pathological specimens,and familialPTMC are rather rare. Careful palpation,color Doppler uhrasonography, exploratory operation and frozen section are very important factors to heighten diagnosis of PTMC. Lobectomy is the routine radical operation.