Analysis Of Clinical Patients With Thyroid Microcarcinoma

Objective To investigate the clinical characteristics,diagnosis and treatment for thyroid microcarcinoma(TMC).Methods The clinical data of 262 TMC patients confirmed by surgical and pathological findings from January 2011 to June 2014 were reviewed,and were comparatively analyzed with the data of 90 patients with benign thyroid nodules(BTN)confirmed by pathology who during the same period of time underwent surgery.Results Of the 262 TMC patients,260 cases were papillary TMC,1 case was follicular TMC,and 1 case was undifferentiated TMC;246 cases(93.9%)were diagnosed as TMC by intraoperative frozen section,16 cases were diagnosed as benign thyroid disease and were confirmed TMC by postoperative pathological;126 cases(48.09%)were complicated with nodular goiter、18 cases(6.87%)with thyroid adenoma,27 cases(10.30%)with chronic lymphocytic thyroiditis,and 3 cases with hyperthyroidism.In TMC patients,hemalignancy diagnostic rate by the low echo,the micro calcification,blood flow signal is rich,TI-RADS classification were all significantly higher than those that in BTN patients(all P<0.05).All patients received surgical treatment that included ipsilateral thyroidectomy plus isthmectomy in 73 cases,subtotal thyroidectomy in 153 cases and total thyroidectomy in 36 cases.There are 172 cases that received lymph node dissection.Centural lymph node dissection has been operated on 162 patients,which 45 cases(27.78%)appeared metastasis and 10 cases that accepted additional ipsilateral functional neck dissection have appeared metastasis.The central cervical lymph node metastasis in TMC group was significantly associated with tumor size,multifocality(all P<0.05).Compared with no received centural lymph node dissection,patients received centural lymph node dissection have no obvious difference on short-term postoperative complications(χ2=0.09,P>0.05).Seleceted different ways of operation according to the size and number and compared the recurrence rate after surgery,the difference was not statistically significant(χ2=2.89,P>0.05).Conclusion Papillary carcinoma of the thyroid is the main type of TMC,and high-resolution ultrasonography is an impor-tant method to diagnose TMC.Patients with TMC should be treated with " indicid ual surgery",operated according to tumor number and size in ipsilateral t hyroidectomy plus isthmectomy and total or most thyroidetomy,at the same time routinely dissect the same side central lymph nodes.If the patients are highly suspected or sure with metastases of lymph nodes in the neck before the surgery,the surgeons would add functional neck lymph node dissection.