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目的 探讨隐匿性甲状腺癌的诊治经验。方法 回顾性分析了 32 例隐匿性甲状腺癌的临床资料。结果 术前6例疑甲状腺癌,仅1例确诊,23例术中冷冻切片确诊,8例术后确诊。乳头状癌29例,滤泡状癌2例,髓样癌1例。术后除1例出现颈淋巴结转移,行第2次手术外,其余未发现复发或转移。结论 隐匿性甲状腺癌术前不易诊断,彩超、细针穿刺活检和术中冷冻检查可提高诊断率,对局限性或包膜内的、无淋巴结转移的隐匿性甲状腺癌,应首选患侧腺叶及峡部切除术。如癌灶已穿透甲状腺包膜,特别是已有淋巴结转移者,仍应行颈淋巴结清扫术。
Objective To investigate the diagnosis and treatment of occult thyroid cancer. Methods Retrospective analysis of 32 cases of occult thyroid cancer clinical data. Results Six cases had suspected thyroid cancer before surgery. Only one case was diagnosed, 23 cases were confirmed by frozen section and 8 cases were diagnosed postoperatively. Papillary carcinoma in 29 cases, follicular carcinoma in 2 cases, medullary carcinoma in 1 case. In addition to 1 case of cervical lymph node metastasis, the second line of surgery, the rest did not find recurrence or metastasis. Conclusion Occult thyroid cancer is not easy to diagnose preoperatively, and color Doppler ultrasonography, fine needle aspiration biopsy and intraoperative cryosurgery can improve the diagnostic rate. For the limited or envelopment of occult thyroid carcinoma without lymph node metastasis, And isthmus resection. If the foci have penetrated the thyroid capsule, especially those who have lymph node metastasis, cervical lymph node dissection should still be performed.