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甲状腺癌特别是分化型误诊率比较高，国内外各家报道在５０％左右，在基层医院误诊率更高。有报道，甲状腺癌诊为良性结节切除后残癌率在５０％～７０．２０％。我科近８年对分化型甲状腺癌误按良性病变切除后再次手术的３２例患者进行治疗总结，现报告如下。１临床资料本组３２例，男１５例，女１７例；年龄１６～６７岁。两次手术间隔时间９～４５天。病理类型：乳头状癌２６例，滤泡状癌６例。误诊原因：２３例第一次手术在基层医院，９例在本院，均未做冰冻切片病理检查或报告阴性。第２次手术方式和病理检查结果见表１。表１手术方式手术方式例数患侧残余腺叶＋峡部切除５患侧残余腺叶＋峡部＋对侧次全切除３患侧残余腺叶、峡部、对侧次全＋改良颈淋巴结清扫２４３２例切除标本中有残癌者２４例，其中患侧腺叶残癌者２２例，合并颈淋巴结有转移者７例，峡部有残癌者（均为肿物单纯切除）２例，患侧单纯颈淋巴结有转移者２例。残癌的病理类型：乳头状腺癌２１例，滤泡状癌３例。首次手术与残癌的关系见表２。表２首次手术与残癌手术方式（例）残癌例数残癌率（％）单纯肿物切除（１３）１２９２．３１患侧腺叶部分切除（１２）１１９１．６７患侧腺叶全切（７）１１４．２９其他因素与残癌关系肿瘤?
The rate of misdiagnosis of thyroid cancers, especially differentiated ones, is relatively high, and they are reported by about 50% at home and abroad. The rate of misdiagnosis in primary hospitals is even higher. It has been reported that thyroid cancer diagnosed with benign nodules has a residual cancer rate of 50% to 70.20%. In the past 8 years, our department has summarized the treatment of 32 patients with misdiagnosed thyroid cancer by mistake after benign lesion resection. The report is as follows. 1 clinical data in this group of 32 cases, 15 males and 17 females; aged 16 to 67 years old. The interval between two operations is 9 to 45 days. Pathological types: 26 cases of papillary carcinoma, follicular carcinoma in 6 cases. Misdiagnosis reasons: 23 cases of the first operation in primary hospitals, 9 cases in our hospital, were not frozen section pathological examination or reported negative. The results of the second surgical procedure and pathological examination are shown in Table 1. Table 1 Surgical methods Surgical methods Number of ipsilateral residual glands + isthmectomy 5 Ipsilateral residual glands + isthmus + contralateral subtotal resection 3 Remnant gland lobes, isthmus, contralateral subtotal + improved cervical lymph node dissection 2432 cases There were 24 cases of residual cancer in the resection specimens, including 22 cases of cancer of the adenocarcinoma of the affected side, 7 cases of metastasis of the cervical lymph node, and 2 cases of residual cancer in the isthmus (resection of the tumor alone), and the ipsilateral ipsilateral neck. There were 2 cases with lymph node metastases. Pathological types of residual cancer: papillary adenocarcinoma in 21 cases, follicular carcinoma in 3 cases. The relationship between the first surgery and residual cancer is shown in Table 2. Table 2 First surgery and residual cancer surgery (Example) residual cancer cases residual cancer rate (%) simple tumor resection (13) 1292.37 Partially removed lobes (12) 1191.67 Sensitized glands (7) 114.29 Other factors related to residual cancer Tumors?