【摘要】 目的：研究国人隐匿型甲状腺癌（ＯＴＣ）的诊治及生物学行为。方法：采用本院１９７６～１９９５年收治的２１９例分化型甲状腺癌（ＤＴＣ），其中ＯＴＣ４１例进行随访。结果：非隐匿型甲状腺癌中有更多甲状腺外浸润，但ＯＴＣ多灶性更多见，淋巴结转移两者差异无显著性。３７例ＯＴＣ病人有随访结果，平均随访１０年，只有１例（２．４％）死于ＯＴＣ肺转移。有４例分别于术后２～６年复发，总复发率１０．８％。经统计初次手术类型为复发相关因素，甲状腺部分切除术后复发明显高于患侧一叶及更大范围切除术后。４１例ＯＴＣ中术前诊断（包括怀疑恶性）仅１６例。结论：ＯＴＣ病人的１０年生存率达９１．９％；ＯＴＣ占同期ＤＴＣ的１９％，应综合应用Ｂ超、ＦＮＡＢ、冰冻病理等提高诊断率；首次手术应行一叶切除术，临床诊断淋巴结转移再行改良颈淋巴结清扫术。更多还原

【Abstract】 Objective: To elucidate the clinical presentations and results of treatment in the patients with occult thyroid carcinoma （OTC） in China. Methods: The data of 219 patients with pathologically verified papillary and follicular thyroid carcinomas （PTC &FTC） who received treatment in the First Hospital of Beijing Medical University were retrospectively reviewed. 41 OTC patients were followed up. Results: After χ₂ analysis in patients with OTC, very few incidences of extrathyroid invasion and more multifocal were found, but the lymphatic metastasis had no significant difference between OTC and non-occult thyroid carcinoma cases. Among 41 patients with OTC, 37 had been followed up, the average time of follow-up was ten years. From a multivariate and univariate analysis of more than 370 patientyears’ experience with OTC, we found that only one case （2.4%） died of distant metastasis （lung） of the occult papillary thyroid carcinoma. And there were four recurrent cases with OTC （4/37）during the 2-6 years right after the first surgical treatment. The different recurrent between the ipsilateral lobectomy or more and only partial lobectomy was significant. Only 16 cases of OTC were diagnosed before operation. Conclusion: The tenyear survival rate of OTC was 91.9%, and OTC was 19% of differentiated thyroid carcinoma. We should make better use of the ultrasonography, freezing section and the fine needle aspiration biopsy. The first operation should be ipsilateral lobectomy or more. The modified neck dissection can be done after the diagnosis of lymphatic metastasis.更多还原