目的探讨甲状腺乳头状微小癌(papillary thyroid microcarcinoma,PTMC)的临床特点、诊断及治疗方式。方法回顾性分析118例PTMC患者的临床病理资料。结果 PTMC合并甲状腺良性疾病84例(71.2),颈部淋巴结转移48例(40.7),<45岁与≥45岁PTMC患者颈部淋巴结转移的发生率有显著性差异(30.2vs.49.2,P<0.05)。患侧腺叶、峡部切除加中央区淋巴结清扫术作为主要手术方式。103例随访时间9～128个月,平均69个月,无死亡病例,未发现远处转移。结论术前B超检查、术中探查及冰冻病理检查有助于PTMC早期诊断,合适的手术方式对PTMC的治疗及预后极为重要。 Objective To investigate the clinical features, diagnosis and treatment of papillary thyroid microcarcinoma (PTMC). Methods The clinical and pathological data of 118 patients with PTMC were retrospectively analyzed. Results There were 84 cases (71.2%) of thyroid benign disease, 48 cases (40.7%) of cervical lymph node metastasis and 45 cases of PTMC. The incidence of cervical lymph node metastasis was significantly different between PTMC group (30.2 vs.49.2, P < 0.05). Ipsilateral lobular, isthmic resection plus central lymph node dissection as the main surgical approach. 103 cases were followed up for 9 to 128 months with an average of 69 months without death and no distant metastasis was found. Conclusion Preoperative B-ultrasound, intraoperative exploration and frozen pathological examination are helpful for the early diagnosis of PTMC. Appropriate surgical methods are very important for the treatment and prognosis of PTMC.