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本文报告甲状腺乳头状癌241例。其中,追踪10年以上者137例。分颈淋巴结清除术、腺叶切除术和姑息治疗三组进行观察。本组病人主要死因是癌瘤局部浸润、复发和远处转移;临床无颈淋巴结肿大者而仅行腺叶切除后追踪10年以上,皆未发现颈淋巴结肿大。行治疗性颈淋巴结清除术组获96％10年生存率的疗效。据此,可认为此癌无必要施行预防性颈清除术。尤其本病以青年女性多见,更应使患者术后获得较理想的生存质量。影响预后因素:40岁以下组,局部无浸润,肿瘤小于5cm及Ⅰ、Ⅱ期者的10年生存率分别明显高于40岁以上组和局部有浸润者或肿瘤在5cm以上及Ⅲ期者。
This article reports 241 cases of thyroid papillary carcinoma. Among them, 137 cases were followed for more than 10 years. The three groups of cervical lymph node dissection, lobectomy and palliative treatment were observed. The main cause of death in this group of patients was local invasion, recurrence, and distant metastasis of cancerous tumors; in patients without cervical lymphadenopathy, only lymph node metastasis was observed after lobectomy for more than 10 years. The therapeutic cervical lymph node dissection group achieved a 96% 10-year survival rate. Based on this, it can be considered that this cancer is not necessary to perform preventive neck dissection. In particular, this disease is more common in young women, but it should also enable patients to obtain better quality of life after surgery. Factors affecting prognosis: In the 40-year-old group, there was no local infiltration, and the 10-year survival rate of tumors smaller than 5 cm and stage I and II were significantly higher than those of patients over 40 years old and those with local infiltration or tumors above 5 cm and stage III, respectively.