Melliere D, Danis R K, Lasry G
Nouv Presse Med. 1979 Apr 14;8(17):1399-402.
In a serie of 607 cold nodules developing in normal or apparently normal (on preoperative clinical examination) thyroids, the results of histopathological examination were compared with those in an identical series studied 10 years before. Carcinoma was frequent: 9.7% in the current series and 19% in the first series. Insofar as neither clinical examination nor special investigations at the present time make it possible to affirm that a cold nodule is not malignant, surgical complete lobectomy with frozen section examination remains the required procedure in view of its harmless nature and the good prognosis in differentiated tumours operated upon before any visceral extension has taken place, contrasting with the poor prognosis of others. Recurrences may be prevented by special operative techniques (routine excision of Lalouette's pyramid, division of the contralateral ligament of Grubert) and routine postoperative thyroid extracts in patients with a morphological, familial or biological risk of recurrence.
在一组607个发生于正常或术前临床检查看似正常的甲状腺的冷结节中，将组织病理学检查结果与10年前研究的同一组病例进行了比较。癌并不少见：当前这组病例中为9.7%，第一组中为19%。鉴于目前无论是临床检查还是特殊检查都无法确定一个冷结节不是恶性的，鉴于其无害性质以及在发生任何内脏转移之前进行手术的分化型肿瘤预后良好，而其他肿瘤预后较差，因此手术完整叶切除加冰冻切片检查仍然是必要的程序。通过特殊的手术技术（常规切除拉洛埃特锥体、切断对侧格鲁伯特韧带）以及对有形态学、家族性或生物学复发风险的患者术后常规使用甲状腺提取物，可以预防复发。
