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目的探讨甲状腺乳头状微小癌的临床特点、诊断和外科治疗方式。方法回顾分析我院1989～2004年治疗的78例甲状腺乳头状微小癌的临床资料。结果78例甲状腺乳头状微小癌中65例术前拟诊甲状腺良性病变,而术中或术后发现为甲状腺乳头状微小癌。对原发灶均行一侧腺叶及以上切除。6例行功能性颈淋巴清扫均有淋巴结转移。32例行预防性喉返神经旁淋巴结清扫,仅有1例淋巴结转移。78例随访6个月～10年,无1例死亡。结论甲状腺乳头状微小癌多易拟诊为良性病变,B超可明显提高甲状腺乳头状微小癌的检出率,其预后佳,腺叶切除可作为主要手术方式,对临床淋巴结肿大者行同侧功能性颈淋巴清扫术。
Objective To investigate the clinical features, diagnosis and surgical treatment of thyroid papillary microcarcinoma. Methods The clinical data of 78 cases of papillary thyroid carcinoma treated in our hospital from 1989 to 2004 were retrospectively analyzed. Results Among the 78 cases of thyroid papillary micro-carcinoma, 65 cases were preoperatively diagnosed as benign thyroid gland lesions, while intraoperative or postoperative findings were papillary thyroid carcinoma. On the side of the primary tumor were removed above the glandular lobes. 6 cases of functional cervical lymph node dissection have lymph node metastasis. 32 cases of prophylactic repair of the recurrent laryngeal nerve lymph nodes, only 1 case of lymph node metastasis. 78 cases were followed up for 6 months to 10 years, no one died. Conclusions The thyroid papillary microcarcinoma is more likely to be diagnosed as benign lesions, B ultrasound can significantly improve the detection rate of thyroid papillary microcarcinoma, the prognosis is good, lobectomy can be used as the main surgical approach to clinical lymph nodes with the line Lateral functional neck dissection.