Kuznetsov N S, Vanushko V E, Voskoboĭnikov V V, Artemova A M, Soldatova T V
Khirurgiia (Mosk). 2001(4):4-9.
Long-term results of treatment of 280 patients operated for multinodal euthyroid goiter (MNEG) in surgical department of Endocrinology Research Center RAMS from 1983 to 1997 were studied. Hormonal examination of peripheral blood, ultrasonic examination of thyroid gland (TG) and zones of regional lymph outflow, thin-needle punch biopsy were used as special methods of investigation. Correlation between recurrence and histological form was studied. In cystic-colloid goiter with adenomatosis the recurrence of MNEG was revealed in 15 (34.1%) cases. In primary multiple TG adenomas of different types the number of recurrences was smallest--1 (3.3%) cases. There were no recurrences in cancer of TG in combination with cystic-colloid goiter or adenomas of TG. Recurrence of cystic-colloid goiter was revealed in 5 (5.7%) cases, different types of adenomas--in 5 (5.7%) cases. The smallest number of recurrences of MNEG was seen after maximum subtotal resection of TG--in 4 patients (7.7% of the patients with this volume of operation). In all the 12 cases of partial resection of TG the recurrence of different morphological forms of MNEG was revealed. Influence of thyroid therapy on remote recurrence rate in different form of MNEG was also studied. In cystic-colloid goiter (CCG) of different proliferation degree with adenomatosis the recurrence rate was not significantly different irrespective of hormonal therapy--29.4%, 37.5% and 36.4%, respectively, in adequate therapy, inadequate therapy and its absence, that testifies to small influence of thyroid therapy on reduction of recurrence rate in this group of patients. The highest recurrence rate in CCG and CCG with adenomas of TG was revealed in the group without thyroid therapy--30.8% and 35.7%, respectively.
对1983年至1997年在俄罗斯医学科学院内分泌研究中心外科接受多结节甲状腺肿（MNEG）手术治疗的280例患者的长期治疗结果进行了研究。采用外周血激素检查、甲状腺（TG）及区域淋巴引流区超声检查、细针穿刺活检作为特殊检查方法。研究了复发与组织学类型之间的相关性。在伴有腺瘤形成的囊性胶样甲状腺肿中，MNEG复发15例（34.1%）。在不同类型的原发性多发性TG腺瘤中，复发例数最少——1例（3.3%）。TG癌合并囊性胶样甲状腺肿或TG腺瘤未出现复发。囊性胶样甲状腺肿复发5例（5.7%），不同类型腺瘤复发5例（5.7%）。TG最大次全切除术后MNEG复发例数最少——4例患者（占该手术量患者的7.7%）。在所有12例TG部分切除病例中，均发现了不同形态学类型的MNEG复发。还研究了甲状腺治疗对不同形式MNEG远期复发率的影响。在伴有腺瘤形成的不同增殖程度的囊性胶样甲状腺肿（CCG）中，无论激素治疗情况如何，复发率无显著差异——在充分治疗、不充分治疗及未治疗组中分别为29.4%、37.5%和36.4%，这表明甲状腺治疗对该组患者降低复发率的影响较小。在未进行甲状腺治疗的组中，CCG及CCG合并TG腺瘤的复发率最高——分别为30.8%和35.7%。
