Chigot J P, Leenhardt L
Service de Chirurgie, Hôpital de la Pitié, Paris.
Ann Endocrinol (Paris). 1997;58(4):330-4.
Most of the papillary thyroid microcarcinomas have an excellent prognosis, though some of them, like macrocarcinomas, lead to local recurrences or distant metastasis. Detection of high risk factors to choose between conservative or aggressive treatment would be essential but is difficult and controversial, criterias being multiple. This is why we favour in most instances total or near total thyroidectomy with nodal dissection, morbidity of this surgery being very low. TSH suppression treatment is routinely advocated but not adjunctive radioiodine ablation. This approach authorizes an easier long term follow up.
大多数甲状腺微小乳头状癌预后良好,不过其中一些,与大癌灶一样,会导致局部复发或远处转移。检测高危因素以在保守治疗或积极治疗之间做出选择至关重要,但这既困难又存在争议,因为标准是多方面的。这就是为什么在大多数情况下我们倾向于行全甲状腺切除或近全甲状腺切除并清扫淋巴结,这种手术的发病率非常低。常规提倡促甲状腺激素(TSH)抑制治疗,但不主张辅助性放射性碘消融治疗。这种方法便于进行更轻松的长期随访。