Block M A
Compr Ther. 1987 Jun;13(6):48-56.
Thyroid nodules are a frequent finding but engender concern primarily because of a large size or, occasionally, as a manifestation of a carcinoma. Needle biopsy permits a definite diagnosis in the majority of cases. Well-differentiated thyroid carcinoma is treated by surgery, the extent of which would be based on the gross evidence of the extent of the disease, the histologic features of the lesion, the patient's age and overall medical status, and the need to avoid postoperative complications. The appropriate care after surgery is also based on the individual patient. Medullary thyroid carcinoma is best treated by total thyroidectomy with cervical lymph node dissection on the side of a palpable nodule. Serum calcitonin determinations provide diagnostic and some prognostic data. Anaplastic carcinoma is usually best treated by radiation therapy. The outlook is good for most thyroid carcinoma recognized reasonably early.
甲状腺结节很常见，但主要因其体积较大或偶尔作为癌的一种表现而引起关注。针吸活检在大多数情况下可作出明确诊断。分化良好的甲状腺癌通过手术治疗，手术范围将基于疾病范围的大体证据、病变的组织学特征、患者的年龄和总体健康状况以及避免术后并发症的需要。术后的适当护理也因人而异。髓样甲状腺癌最好通过全甲状腺切除术加可触及结节一侧的颈部淋巴结清扫术进行治疗。血清降钙素测定可提供诊断和一些预后数据。未分化癌通常最好通过放射治疗。大多数早期得到合理诊断的甲状腺癌预后良好。
