Analysis of the Characteristics of Papillary Thyroid Carcinoma and Discussion on the Surgery (Experience of 392 Cases)

摘要

The incidence of papillary thyroid carcinoma is increasing in recent years. In order to investigate the biological characteristic of papillary thyroid carcinoma and to discuss on the surgery, we collected clinical data of 392 patients who were diagnosed thyroid papillary carcinoma and underwent total thyroidec-tomy and conventional central lymph node dissection from January, 2010 to December 2012 in the First Hospital of Jilin University. The operations of 392 cases were all successful. There was no permanent iatrogenic injury of recurrent laryngeal nerve. Only one patient had a permanent hypoparathyroidism. There was bilateral cancer in 112 cases (28.6 %). Thyroid membrane invasion was found in 249 cases (63.5 %), in which the invasion rate of bilateral cancer rate was 44.6 % (50/112). Central cervical lymph node metastasis was found in 191 cases (48.7 %), in which central cervical lymph node metastasis of bilateral cancer rate was 53.6 % (60/112) and of unilateral cancer rate was 46.8 % (131/280). The central cervical lymph node metastasis of thyroid membrane invasion rate was 48.6 % (121/249). The thyroid membrane invasion or cervical lymph node metastasis rate in all cases were 81.4 % (319/392). 62 cases of 112 cases bilateral thyroid papillary carcinoma were diagnosed suspicious unilateral cancer and the rate was 55.4 % (62/112). According to the results, papillary thyroid carcinomas often occur bilaterally and the ration of central cervical lymph node metastasis is very high. We suggest most patients with thyroid papillary carcinoma should undergo total thyroidectomy and conventional central lymph node dissection and combined with I131 and hormonal treatments.