中国实用外科杂志2025，Vol.45Issue(9)：1032-1035,4.DOI:10.19538/j.cjps.issn1005-2208.2025.09.13
弥漫硬化型甲状腺乳头状癌26例诊治分析
Diagnosis and treatment analysis of 26 cases of diffuse sclerosing variant of papillary thyroid carcinoma
摘要
Abstract
Objective To explore the key aspects in the diagnosis and treatment of the diffuse sclerosing variant of papillary thyroid carcinoma(DSVPTC).Methods A retrospective analysis was conducted based on 26 patients with DSVPTC treated at the Department of Thyroid Surgery,Jilin University China-Japan Union Hospital from January 2015 to September 2022.The study encompassed general patient information,ultrasound,fine-needle aspiration cytology,paraffin pathology results,and comprehensive postoperative treatment plans.Relevant literature was also reviewed.Results Among the 26 patients,the majority were females(21/26,80.8％),with an average age of 31.6 years.All patients underwent surgical treatment after preoperative diagnosis,among which 8 cases underwent total thyroidectomy with lymph node clearance(bilateral Ⅵ region,bilateral Ⅱ,Ⅲ,Ⅳ,Ⅴ regions),10 cases underwent total thyroidectomy with lymph node clearance(bilateral Ⅵ region,unilateral Ⅱ,Ⅲ,Ⅳ,Ⅴ regions),1 case underwent total thyroidectomy with lymph node clearance(bilateral Ⅵ region),3 cases underwent unilateral thyroid lobectomy and isthmus resection with lymph node clearance(bilateral Ⅵ region,unilateral Ⅱ,Ⅲ,Ⅳ,Ⅴ regions),and 4 cases underwent unilateral thyroid lobectomy and isthmus resection with lymph node clearance(bilateral Ⅵ region).Postoperative pathology revealed a significantly high rate of cervical lymph node metastasis in these cases(central region:92.3％;lateral neck region:76.9％),and 15 patients of them had concomitant Hashimoto's thyroiditis(57.7％).Additionally,4 patients were found to have concomitant classical papillary thyroid carcinoma(CPTC).Postoperatively,17 patients received iodine-131 treatment and all patients underwent endocrine suppression therapy.With regular follow-ups,the minimum follow-up time was 4 months and the maximum was 88 months.Two patients were lost to follow-up,and the median follow-up time was 19 months.There was no recurrence or metastasis during the follow-up period.Conclusion DSVPTC is more common in young females,characterized by a high rate of lymph node metastasis and complex and variable local imaging.Preoperative diagnosis should be made by combining multiple examinations.Treatment requires a more active and comprehensive strategy.关键词
甲状腺乳头状癌/弥漫硬化型/超声检查/临床病理特征Key words
papillary thyroid carcinoma/diffuse sclerosing variant/ultrasonography/clinical and pathological characteristics分类
医药卫生引用本文复制引用
何润东,付庆锋,张帅,孙平,孙辉,周乐..弥漫硬化型甲状腺乳头状癌26例诊治分析[J].中国实用外科杂志,2025,45(9):1032-1035,4.基金项目
国家自然科学基金面上项目(No.81972499) （No.81972499）
吉林大学研究生创新基金资助项目(No.2024CX268) National Natural Science Foundation of China General Project(No.81972499) （No.2024CX268）
Graduate Innovation Fund of Jilin University(No.2024CX268) （No.2024CX268）
