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目的：研究国人隐匿型甲状腺癌（ＯＴＣ）的诊治及生物学行为。方法：采用本院１９７６～１９９５年收治的２１９例分化型甲状腺癌（ＤＴＣ），其中ＯＴＣ４１例进行随访。结果：非隐匿型甲状腺癌中有更多甲状腺外浸润，但ＯＴＣ多灶性更多见，淋巴结转移两者差异无显著性。３７例ＯＴＣ病人有随访结果，平均随访１０年，只有１例（２．４％）死于ＯＴＣ肺转移。有４例分别于术后２～６年复发，总复发率１０．８％。经统计初次手术类型为复发相关因素，甲状腺部分切除术后复发明显高于患侧一叶及更大范围切除术后。４１例ＯＴＣ中术前诊断（包括怀疑恶性）仅１６例。结论：ＯＴＣ病人的１０年生存率达９１．９％；ＯＴＣ占同期ＤＴＣ的１９％，应综合应用Ｂ超、ＦＮＡＢ、冰冻病理等提高诊断率；首次手术应行一叶切除术，临床诊断淋巴结转移再行改良颈淋巴结清扫术。
Objective: To study the diagnosis, treatment and biological behavior of Chinese patients with occult thyroid carcinoma (OTC). METHODS: A total of 219 cases of differentiated thyroid carcinoma (DTC) were treated in our hospital from 1976 to 1995, and 41 cases of OTC were followed up. RESULTS: There were more extrathyroidal infiltration in non-occult thyroid carcinoma, but more multifocal OTC lesions and no significant difference in lymph node metastasis. 37 patients with OTC had follow-up results. The average follow-up period was 10 years. Only 1 patient (2.4%) died of OTC lung metastasis. Four patients relapsed 2 to 6 years after surgery, and the total recurrence rate was 10.8%. According to statistics, the type of primary surgery was related to recurrence, and the recurrence after partial thyroidectomy was significantly higher than that of the ipsilateral one and larger range. 41 cases of OTC preoperative diagnosis (including suspected malignant) only 16 cases. Conclusions: The 10-year survival rate of OTC patients is 91.9%; OTC accounts for 19% of DTCs in the same period, and B-ultrasound, FNAB, frozen pathology, etc. should be comprehensively used to improve the diagnosis rate; the first operation should be performed with one-lobectomy and clinically diagnosed lymph nodes. Metastasis was followed by modified neck dissection.