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目的探讨一叶甲状腺有单个较小癌结节的患者术后有无进行131I清甲的必要性。方法采用回顾性分析方法,将行甲状腺次全切除术或全切除术后经病理确诊为乳头状甲状腺癌患者105例,按结节大小分为≤1 cm、>1 cm~≤2 cm、>2 cm~≤3 cm组,各组再按未服或服用放射性131I分为两组,比较两组的年龄、性别比、甲状腺癌结节部位、手术方式、术后随访时间及复发例数。服用131I者,按要求进行清甲是否完全的评估,直到清甲成功。结果 >2 cm~≤3 cm组未服131I者与服用131I者各项指标比较,差异均无统计学意义(P>0.05),≤1 cm组未服131I者甲状腺癌结节位于左叶者明显多于服131I者(P<0.01)。>1 cm~≤2 cm组未服131I者甲状腺全切除术式明显少于服131I者(P<0.01)。三组中未服131I者中位随访时间73个月,服用131I组者中位随访时间32个月,≤1 cm组及>1 cm~≤2 cm组患者均未见复发,>2 cm~≤3 cm组未服131I者复发3例(18.8%),服用131I者未见复发,两者比较,差异无统计学意义(P>0.05)。32例患者服1次131I即清甲成功,12例患者服2次131I清甲成功,1次清甲成功率72.8%。结论一侧甲状腺有单个较小癌结节(≤2 cm)的患者,术后为避免131I清甲的潜在伤害可不清甲,而癌结节为>2 cm~≤3 cm者为减少复发建议行131I清甲治疗。
Objective To investigate the necessity of 131I treatment of patients with single small thyroid cancer nodules. Methods A retrospective analysis was performed in 105 cases of papillary thyroid carcinoma diagnosed by subtotal thyroidectomy or total resection. According to the size of the nodules, 105 cases were classified as ≤1 cm,> 1 cm ~ ≤2 cm and> The patients in each group were divided into two groups according to the age, sex ratio, thyroid cancer nodules, operation method, postoperative follow-up time and number of recurrence. Take 131I who, according to the requirements of the full assessment of Chlamydia, until the success of Chrysalis. Results There was no significant difference between the two groups (P> 0.05). However, there was no significant difference between the groups of 131 cm and 131 I who took 131I Obviously more than taking 131I (P <0.01). Total 131I thyroidectomy group was significantly less than 131I (P <0.01) in the group of> 1 cm ~ <2 cm. The median follow-up time was 73 months in the three groups without 131I, and the median follow-up time in the 131I group was 32 months. No recurrence was found in the patients ≤1 cm and> 1 cm ~ ≤2 cm, In the group of ≤3 cm, those who did not take 131I had recurrence in 3 cases (18.8%). No recurrence was found in 131I patients. There was no significant difference between the two groups (P> 0.05). 32 cases of patients taking 131I that is, success of a clear arm, 12 patients with two successful 131I armor, a success rate of 72.8% of armor. Conclusions Patients with single small nodules (≤2 cm) on one side of the thyroid gland may have no postoperative A Line 131I treatment of the armor.