Paloyan E, Lawrence A M, Brooks M H, Picleman J R
Surgery. 1976 Jul;80(1):70-6.
In seventy patients with nodular thyroids and a history of radiation exposure, total thyroidectomy disclosed a 54% incidence of carcinoma; more than half of them had cervial node metastases; four had distant metastases. Fourteen patients required radical neck dissection. The carcinoma was multicentric (both lobes) in 45%. In four patients the carcinoma was found in the lobe contralateral to the one containing the palpable nodule. These findings support the advocates of total thyroidectomy for patients with a nodular thyroid and a history of radiation exposure, provided this operation can be performed with a low incidence of recurrent nerve palsy and hypoparathyroidism.
在70例有甲状腺结节且有放射暴露史的患者中，全甲状腺切除术后发现癌的发生率为54%；其中一半以上有颈部淋巴结转移；4例有远处转移。14例患者需要行根治性颈清扫术。45%的癌为多中心性（双侧叶）。在4例患者中，癌位于与可触及结节所在叶对侧的叶中。这些发现支持了对于有甲状腺结节且有放射暴露史的患者行全甲状腺切除术的主张，前提是该手术能够在喉返神经麻痹和甲状旁腺功能减退发生率较低的情况下进行。
