Šafránek J, Třeška V, Skalický T, Špidlen V, Doležal J, Kubačková D, Zeithaml J, Skála M, Hošek P
Rozhl Chir. 2016 Fall;95(11):394-397.
Even though thyroid carcinoma has, in general, a good prognosis and low mortality rate, its incidence, especially the incidence of early forms of the disease has been growing.
Retrospective analysis of the file of surgeries of documented thyroid carcinoma within the years of 2006-2015.
Thyroid carcinoma was recorded in 145 of 1820 patients operated for thyreopathy (8%); microcarcinoma (<10mm) was recorded in 64 cases (44.1%). The carcinoma was mostly detected accidentally during total thyroidectomy, which was in 70 cases (48.3%). The carcinoma was expected in 35 cases (24.1%) on the basis of prior puncture and total thyroidectomy was carried out straight away. Perioperative histology after hemithyroidectomy was requested in 31 cases (21.4%), and it was found positive only in 13 cases; thyroidectomy was finished in the second period in the other cases. Due to advanced carcinoma, tumour exploration/debulking was performed in 3 cases (2.1%) - for anaplastic carcinoma in all these cases. A permanent unilateral lesion - n. laryngeus recurrens - occurred in 3 cases (2.1%); a permanent bilateral lesion was recorded twice (1.4%).The most frequently manifested carcinoma was the papillary carcinoma in 114 patients (78.6%; 83 women/31 men; age of 1284 years; mean age of 50.6), the second most frequent carcinoma was the follicular carcinoma in 16 patients (11.0%; 15/1; 1969; 55.3), followed by the medullary carcinoma in 10 patients (6.9%; 6/4; 2576; 58.1). Anaplastic carcinoma was detected only in 4 cases (2.8%; 2/2; 6487; 75.5), and lymphoma of the thyroid gland occurred twice as well as Hürtle cell carcinoma.
Thyroid carcinoma is mostly found accidentally during surgery in the early phase of the disease. This proves the high quality of endocrinology care and the correctness of the tendency to indicate early surgical treatment of thyroidal pathology.Key words: thyroid carcinoma - thyroidectomy complications.
尽管甲状腺癌总体预后良好、死亡率较低,但其发病率,尤其是早期甲状腺癌的发病率一直在上升。
对2006年至2015年期间有记录的甲状腺癌手术病例档案进行回顾性分析。
在1820例因甲状腺疾病接受手术的患者中,有145例被诊断为甲状腺癌(8%);微癌(<10mm)64例(44.1%)。大多数癌是在全甲状腺切除术中意外发现的,共70例(48.3%)。基于之前的穿刺结果,预计有35例(24.1%)为癌,并立即进行了全甲状腺切除术。31例(21.4%)患者在半甲状腺切除术后进行了术中组织学检查,仅13例结果呈阳性;其他病例在第二期完成了甲状腺切除术。由于癌进展,3例(2.1%)患者进行了肿瘤探查/减瘤手术——所有这些病例均为未分化癌。3例(2.1%)患者出现永久性单侧病变——喉返神经损伤;2例(1.4%)患者出现永久性双侧病变。最常见的癌是乳头状癌,114例(78.6%;83名女性/31名男性;年龄12 - 84岁;平均年龄50.6岁),第二常见的是滤泡状癌,16例(11.0%;15/1;19 - 69岁;平均年龄55.3岁),其次是髓样癌,10例(6.9%;6/4;25 - 76岁;平均年龄58.1岁)。仅4例(2.8%;2/2;64 - 87岁;平均年龄75.5岁)发现未分化癌,甲状腺淋巴瘤和许特尔细胞癌各出现2例。
甲状腺癌大多在疾病早期手术时意外发现。这证明了内分泌科护理的高质量以及对甲状腺疾病早期手术治疗倾向的正确性。关键词:甲状腺癌 - 甲状腺切除术并发症