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著者报道457例甲状腺结节,其中405例为肿瘤,恶性者76例,占16.6％;“交界”瘤20例,占4.4％。甲状腺扫描示凉结节或冷结节时,23％可为恶性。术前或术中行针吸或冰冻切片检查有利于决定手术式。单发甲状腺结节以腺叶切除或腺叶大部切除为好,即使病理为癌,亦可紧密观察。著者认为无颈部淋巴结转移的甲状腺癌,宜行患侧腺叶切除术,勿需行予防性颈部清除术。对局部晚期癌,若有可能,宜行姑息性切除,术后补加放疗,仍可收到较满意疗效。
The authors reported 457 thyroid nodules, of which 405 were tumors, 76 were malignant, accounting for 16.6%, and 20 were “junctional” tumors, accounting for 4.4%. When the thyroid scan shows cold or cold nodules, 23% can be malignant. Preoperative or intraoperative needle aspiration or frozen section examination is beneficial to determine the surgical style. Single thyroid nodules are best done with lobectomy or subtotal lobectomy. Even if the pathology is cancer, they can be closely observed. The authors believe that thyroid cancer without cervical lymph node metastasis should be performed with ipsilateral lobectomy and no need for preventive neck dissection. For locally advanced cancer, if possible, palliative resection should be performed, and postoperative supplementation of radiotherapy can still receive satisfactory results.