高俊

[摘要]目的 探讨手术联合131I、甲状腺片治疗甲状腺乳头状癌的效果。方法 将2013年3月～2014年3月在我院普外科治疗的78例甲状腺乳头状癌患者随机分为对照组和观察组，每组各39例。对照组采用胸乳入路腔镜手术切除甲状腺治疗，观察组在此基础上服用131I、甲状腺片治疗，比较两组3年生存率、复发率、术后各项细胞因子水平。结果 观察组3年生存率明显高于对照组，而复发率明显低于对照组，差异有统计学意义（P<0.05）；两组治疗后3、6个月的血清肿瘤抑制基因（p53）、细胞凋亡信号受体（Fas）、肿瘤坏死因子-α（TNF-α）细胞周期素E（CyclinE）蛋白与术后即刻比较，差异均有统计学意义（P<0.05）；观察组治疗后3、6个月p53、Fas、TNF-α、CyclinE与对照组比较，差异有统计学意义（P<0.05）。结论 手术联合131I、甲状腺片治疗甲状腺乳头状癌效果显著，能持续抑制肿瘤发展，延长生存周期，降低复发率，有积极的临床意义。

[关键词]甲状腺乳头状癌；胸乳入路腔镜手术；131I；甲状腺片

[中图分类号] R736.1 [文献标识码] A [文章编号] 1674-4721（2018）5（b）-0069-03

Effect of surgery combined with 131I and Thyroid Tablets in the treatment of thyroid papillary carcinoma

GAO Jun

Department of General Surgery，Jiangxi Hospital of Integrated Chinese and Western Medicine，Jiangxi Province，Nanchang 330000，China

[Abstract]Objective To investigate the effect of surgery combined with 131I and Thyroid Tablets in the treatment of papillary thyroid carcinoma.Methods 78 patients with thyroid papillary carcinoma who were treated in the department of general surgery in our hospital from March 2013 to March 2014 were randomly divided into two groups，39 cases in each group.The control group was given thyroidectomy via endoscopic chest-breast approach.On this basis，the observation group was given 131I and Thyroid Tablets for treatment.Three-year survival rate，recurrence rate and postoperative cytokines levels were compared between the two groups.Results The 3-year survival rate in the observation group was significantly higher than that in the control group，while the recurrence rate was significantly lower than that in the control group，the differences were statistically significant （P<0.05）；serum tumor suppressor gene（p53），Fas，TNF-α and CyclinE protein in the two groups at 3 months and 6 months after treatment were compared with those immediately after the surgery，the differences were statistically significant （P<0.05）；the levels of p53，Fas，TNF-αand CyclinE in the observation group at 3 months and 6 months after treatment were significantly different from those in the control group（P<0.05）.Conclusion Surgery combined with 131I and Thyroid Tablets has a significant effect in the treatment of papillary thyroid carcinoma，which can continue to inhibit tumor development，extend the life cycle and reduce the recurrence rate，and has a positive clinical significance.

[Key words]Papillary thyroid carcinoma；Chest-breast endoscopic surgery；131I；Hyroid Tablets

甲狀腺乳头状癌是一种常见的甲状腺肿瘤类型，占到所有甲状腺肿瘤的80%以上，好发于40岁前的女性，主要表现为颈部无痛性包块，且多伴随吞咽动作而上下移动，病情进展缓慢，但分化程度较高，淋巴转移率高，给临床治疗方案的选择带来一定困难。手术切除甲状腺是临床首选治疗方法，但因远处转移、颈淋巴结转移、原发肿瘤体积等原因导致无法彻底切除干净，对病情的预后产生明显影响[1]。临床研究显示，131I核素治疗及甲状腺激素抑制治疗对减少甲状腺残留、抑制残余肿瘤细胞、改善患者预后有重要临床意义[2]。本研究分析手术联合131I、甲状腺片治疗甲状腺乳头状癌效果，现报道如下。

1资料与方法

1.1一般资料

将2013年3月～2014年3月在我院普外科治疗的78例甲状腺乳头状癌患者随机分为两组，每组各39例。观察组男11例，女28例；年龄24～61岁，平均（38.7±6.9）岁。对照组男12例，女27例；年龄22～59岁，平均（37.6±7.4）岁。……