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1977～1981年,手术治疗3例甲状腺癌,均系女性。2例农民,1例城镇居民。年龄37～43岁。病史:无意中发现一侧甲状腺包块,无明显不适感。检查:一般情况良好,包块在一侧甲状腺内,质地中等,可随吞咽活动,颈部淋巴结不肿大,T_3、T_4值正常,~(131)Ⅰ扫描冷结节。手术见甲状腺内单个结节约2cm×3cm,质地较硬,包块与腺体组织难以分清,术中考虑甲状腺有恶变的可能,行单侧甲状腺全切术。术后病理报告:2例为乳头状腺癌,1例为混合腺癌(乳头状和滤泡状)。随访20余年,无1例复发,生活质量较高。 讨论:甲状腺乳头状腺癌与垂体所分泌的促甲状腺素(TSH)的关系密切。TSH体内增高时能产生甲状
From 1977 to 1981, 3 cases of thyroid cancer were surgically treated and all were female. Two cases of farmers, one case of urban residents. Age 37 to 43 years old. History: Unintentionally discovered one side of the thyroid mass, no obvious discomfort. Examination: Generally good condition, mass in the side of the thyroid, medium texture, with the swallowing activity, the neck lymph nodes are not swollen, T_3, T_4 value is normal, ~ (131) I scanning cold nodules. Surgery see a single knot in the thyroid to save 2cm × 3cm, texture is hard, mass and glandular tissue is difficult to distinguish, the possibility of malignant transformation of the thyroid is considered during surgery, unilateral thyroidectomy. Postoperative pathology report: 2 cases of papillary adenocarcinoma, 1 case of mixed adenocarcinoma (papillary and follicular). After more than 20 years of follow-up, no recurrence occurred and the quality of life was higher. Discussion: Thyroid papillary adenocarcinoma is closely related to the secretion of thyrotropin (TSH) by the pituitary gland. When TSH increases in vivo, it can produce thyroid