【摘要】 本文报告甲状腺乳头状癌241例。其中,追踪10年以上者137例。分颈淋巴结清除术、腺叶切除术和姑息治疗三组进行观察。本组病人主要死因是癌瘤局部浸润、复发和远处转移;临床无颈淋巴结肿大者而仅行腺叶切除后追踪10年以上,皆未发现颈淋巴结肿大。行治疗性颈淋巴结清除术组获96％10年生存率的疗效。据此,可认为此癌无必要施行预防性颈清除术。尤其本病以青年女性多见,更应使患者术后获得较理想的生存质量。影响预后因素:40岁以下组,局部无浸润,肿瘤小于5cm及Ⅰ、Ⅱ期者的10年生存率分别明显高于40岁以上组和局部有浸润者或肿瘤在5cm以上及Ⅲ期者。更多还原

【Abstract】 241 cases of papillary carcinoma of thyroid were mainlytreated surgically in our hospital. Among them, 137 cases were followed up for more than 10 years. Three groups of patients were observed: radical neck dissection, lobectomy and palliative treatment. We found that local infiltration of tumor, local recurrence and distant metastasis were the major cause of death in these groups. Among.the patients without palpable enlarged cervi- cal lymph nodes after lobectomy alone, no adenopathy was found in the 10 years follow up peroid. Meanwhile, the 10 years survival rate for the therapeutic neck dissection was 96%. According to these reasons, we think that prophylactic neck dissection is not necessary, especially for the young woman, , these patients should have better living quality and cosmetic result.The favorable factors of prognosis are. Under 40 years of age, no local infiltration, with tumor less than 5 cm in diameter and at stage Ⅰ,Ⅱ, These patients have apparently higher 10 years survival rate that those older than 40 years, with local infiltration, or with tumor larger than 5 cm in diameter and at stage Ⅲ.更多还原