CAJ | 학술논문

目的：探讨结节性甲状腺肿（NG）合并甲状腺微小癌（TMC）的发生概率及其临床特征，为临床诊治TMC提供依据。方法回顾性分析580例在术前诊断为NG的临床资料，其中28例术后病理诊断为NG合并TMC，统计TMC的发生概率、术中确诊率、漏诊率、复发率及预后。结果 NG合并TMC的发生概率为4.82%（28/580），术中对28例患者做冰冻切片病理检查，25例诊断为NG合并TMC，确诊率为89.28%（25/28），术中冰冻病理检查的漏诊率为10.71%（3/28），术后局部复发率为3.57%（1/28）。本组患者中未发现因甲状腺微小癌死亡者。结论 NG合并TMC术前诊断较为困难，术中仔细探查和快速冰冻切片病理检查有助于提高TMC的诊断率。
목적：탐토결절성갑상선종（NG）합병갑상선미소암（TMC）적발생개솔급기림상특정，위림상진치TMC제공의거。방법회고성분석580례재술전진단위NG적림상자료，기중28례술후병리진단위NG합병TMC，통계TMC적발생개솔、술중학진솔、루진솔、복발솔급예후。결과 NG합병TMC적발생개솔위4.82%（28/580），술중대28례환자주빙동절편병리검사，25례진단위NG합병TMC，학진솔위89.28%（25/28），술중빙동병리검사적루진솔위10.71%（3/28），술후국부복발솔위3.57%（1/28）。본조환자중미발현인갑상선미소암사망자。결론 NG합병TMC술전진단교위곤난，술중자세탐사화쾌속빙동절편병리검사유조우제고TMC적진단솔。
Objective To explore the probability and clinical characteristics of nodular goiter (NG) with coexistent thyroid microcarcinoma(TMC), in order to provide basis for clinical diagnosis and treatment of TMC.Methods The clinical data of 580 patients were preoperative diagnosed of nodular goiter, 28 patients were postoperative pathological diagnosed of NG with TMC, to count the probability of thyroid microcarcinoma, intraoperative diagnosis rate, intraoperative misdiagnosis rate, recurrence rate and prognosis. Results The probability of NG with coexistent TMC was 4.82%(28/580), 28 cases were diagnosed by rapid frozen section intraoperative, the intraoperative diagnosis rate was 89.28%(25/28), missed intraoperative diagnosis of thyroid microcarcinoma rate was 10.71%(3/28), recurrence rate was 3.57%(1/28). Conclusion It was difficult to diagnose NG with TMC preoperatively.The thyroid microcarcinoma diagnostic accuracy rate could be improved by intraoperative careful exploration and intraoperative rapid frozen section.