有报道在分化良好的甲状腺癌病人中,约有10%～20%表现为颈侧部肿块,甲状腺处未能扪及肿瘤,现已明确这是隐性甲状腺癌的颈淋巴结转移,有关其治疗尚存在分岐.在Lahey临床中心,1940～1990年曾治疗885例乳头状或滤泡型甲状腺癌,其中92例表现为颈淋巴结病变而未能扪及甲状腺肿块(以下简称隐性癌).全组病人中位值年龄43岁(5～87岁),而隐性癌组年龄较轻,中位值为34岁(5～73岁).全组男性占27%,而隐性癌组男性占46%,在后者男性中位值年龄40岁,女性29岁.以病理而论,全组乳头状癌占75%,而隐性癌组占25%(p=0.005),包膜侵犯为44%(全组为36%),血管侵犯为38%(全组为33%).≤50岁女性和≤40岁男性列为低危机组(64例),超过上述年龄均为高危机组(27例).低危机组均存活10年,而60%女性和72%男性高危机病人存活.2例低危机病人在术后5年和7年分别发生肺转移和复发,但仍存活. It has been reported that about 10% to 20% of well-differentiated thyroid cancer patients show a mass in the side of the neck and a tumor in the thyroid gland. It is now clear that this is a cervical lymph node metastasis of thyroid cancer, and its treatment is relevant. There is still delivery. In the Lahey Clinic, 885 cases of papillary or follicular thyroid cancer were treated from 1940 to 1990, of which 92 cases showed cervical lymph node lesions and failed thyroid masses (hereinafter referred to as recessive cancer). The median patient age was 43 years old (5 to 87 years old), while the recessive cancer group was younger, with a median of 34 years (5 to 73 years). The total group of men accounted for 27%, while the recessive cancer group was male It accounted for 46%, in the latter male median age 40 years old, female 29 years old. In terms of pathology, the whole group of papillary carcinoma accounted for 75%, while the recessive cancer group accounted for 25% (p=0.005), envelope encroachment It was 44% (36% in the whole group) and the vascular invasion was 38% (33% in the whole group). ≤50-year-old women and ≤40-year-old men were classified as low-risk group (64 cases), exceeding the above ages were high crisis group (27 cases). Low-risk groups all survived for 10 years, while 60% of women and 72% of men with high-risk patients survived. Two patients with low-risk lung metastases and recurrences occurred 5 years and 7 years after operation, but they still survived.