Clinical Analyses Of Diagnosis And Treatment Of 127 Patients With Papillary Thyroid Carcinoma

Obejective:To investigate the clinical diagnosis, surgical treatment, prevention of the surgical complications, postoperative systemical treatment and the factors of the prognosis of papillary thyroid carcinoma.Methods:The clinical data of 127 patients who were selected from the patients with papillary thyroid carcinoma in the First Affiliated Hospital Zhejiang University who receiving surgical intervention, from 1998 to 2006 were analyzed retrospectively and long-term followed up.Results:A total of 127 cases of this study with a median age of 44 years old, the ratio for men to women is about 1:4; of which 122 patients received preoperative B-ultrasonography, accounting for 96.06%; The diagnosis and the choice of operative methods mainly depend on intra-operative frost slice techniques; The operative method of papillary thyroid carcinoma most used was total affected lobectomy plus isthmuss and opposite subtotal lobectomy, accounting for 69.29%; postoperative pathology were papillary thyroid carcinoma, in which a total of 67 patients with papillary thyroid microcarcinoma, accounting for 52.76%; Most of the paitents were in AJCC stage I and account of 77.95%; 7 cases showed surgical complications, whose clinical manifesta-tions were recurrent laryngeal nerve damage (3 cases) and parathyroid gland partly injury (4 cases).120 patinets received the endocrine therapy; With the follow-up,11 cases of them showed recurrence and 1 case was dead.Conclusion:The neck regional ultrasound is valuable in the diagnosis of papillary thyroid carcinoma especially the papillary thyroid microcarcinoma. The thyroid nodule with calcification should be considered to be thyroid carcinoma. The intra-operative frozen section helps to make diagnosis of the papillary thyroid carcinoma and choice of operative methods. Surgeons must well understand and strictly perform detailed surgical proeedures in thyroidectomy of both sides of the thyroid. Recurrent laryngeal nerves must be exposed throughout the operation to avoid the damages on the nerve. The surgical range should be individualized by disease's stage, tumor size, extrathyroidal invasion, lymph node metastasis and distant metastasis. The endocrine therapy can decrease the rate of postoperavie recurrence and metastasis.