Analysis Of86Cases On Surgical And Clinical Treatment Of Thyroid Carcinoma

Thyroid carcinoma, the most common malignant neoplasmof thyroid gland, accounts for about one percent of the malignant tumors of the whole body and about four percent of thyroid diseases.Most of the patients are female and the incidence of this disease is1.49/0.1million which will increase year by year. Most of the thyroid carcinoma differentiates well and has low level of becoming malignant.The main treatment measure is surgical treatment which can produce a better effect. According to pathological types of tumor, thyroid carcinoma can be classified into papillary carcinoma, follicular, medullary carcinoma, undifferentiated carcinoma and so on. The biological feature, clinical manifestation diagnosis and prognosis for thyroid carcinomas of different pathological types are different.Retrospective analysis of the clinical data of86thyroid carcinoma operated patients, who hospitalized in The First Affiliated Hospital of Zhengzhou University from the year2008to2012.Our study is aimed to explore the optimal surgical indications and methods of thyroid carcinoma through our experiences of treatments of thyroid carcinoma by different surgical methods, and provide some guidance value for treatment of thyroid carcinoma.Materials and methods:We retrospectively reviewed the medical records and follow-up outcomes of a consecutive series of86hospitalized patients with thyroid carcinoma from2008to2012, such as their general information (age,gender and course,etc.), clinical manifestations,imaging data (CT,MRI,ECT,etc.), therapeutic schedules and outcomes and so on. And chi-square test were conducted to verify their statistical significance, and then discussed the surgical indications and methods of thyroid carcinoma. Results:The ratio for man to women was1:2.7, there was a significant difference for gender. The average age of thyroid malignant carcinoma was40years old. The main pathological type was differentiation thyroid carcinoma, it was account for89.5%. The papillary carcinoma was about82.6%in differentiation thyroid carcinoma. The main operative method of thyroid carcinoma was total affected lobectomy plus isthmectomy or total affected lobectomy plus isthmectomy plus opposite side subtotal lobectomy. The incidence of the postoperative complications in the total thyroidectomy group was higher than that in the other thyroidectomy group (P<0.05), There were not any significant difference of the rate of the local recurrence and metastasis between two groups (P>0.05). There were not any significant difference in the incidence of the postoperative complication and the rate of the local recurrence and metastasis between the reoperation group and the initial operation group (P>0.05). The prophylactic neck dissection was not suggested. Gender, age, tumor size, infiltration, clinicopathological stage were main factors that influenced the prognosis of thyroid carcinoma.Conclusion:(1).The main pathological type of thyroid carcinoma of this group was differentiation thyroid carcinoma. Most patients with thyroid carcinoma were between21-40years, thyroid carcinoma did not have specific clinical symptoms.(2).The operation was the main treatment. The operation modes should be individualized according to TNM stages, location, size and the situation of lymph metastasis.(3).For the patient those only underwent tumor resection should perform operation again, according to individual condition chose different treatment. The effect of reoperation was satisfactory, recurrence rate and complication were low.(4).Postoperative thyroid replacement therapy and radioactive iodine treatment if necessary can decrease the rate of postoperative recurrence.(5).Gender, age,tumor size, infiltration, clinicopathological stage were main factors that influenced the prognosis of thyroid carcinoma.(6).Differentiated thyroid cancer had favourable prognosis.