分析散发性甲状腺髓样癌原发灶切除范围及对预后的影响。

收集2015年1月至2017年6月期间首诊于天津医科大学肿瘤医院65例散发性甲状腺髓样癌患者的临床资料，分为全甲状腺切除组（A组）和单侧腺叶及峡叶切除组（B组），比较两组患者临床病理特征、生化治愈、复发、无进展生存期。

其中A组25例，B组40例。A组中Ⅰ+Ⅱ期患者8例（32.0%）低于B组23例（57.5%）（χ²=4.010，P=0.045），其余临床病例资料差异无统计学意义。中位随访时间35个月，生化治愈率67.9%（38/56），复发率18.5%（12/65）。A、B两组患者间生化治愈率（63.6% vs 70.6%）、复发率（28.0% vs 12.5%）及无进展生存期[（46.29±3.21）个月vs（61.94±3.58）个月]，差异无统计学意义。

对于散发性甲状腺髓样癌患者，并不一定均采取全甲状腺切除，可选择性行单侧腺叶切除。

To analyze the surgical resection range and prognosis of sporadic medullary thyroid carcinoma (MTC).

Clinical data of 65 sporadic MTC patients firstly treated in Tianjin Medical University Cancer Institute and Hospital from January 2015 to June 2017 were reviewed retrospectively. The patients were divided into total thyroidectomy group (group A) and unilateral lobectomy group (group B), the differences in clinicopathological characteristics, the biochemical cure, recurrence and progression-free survival were compared between the two groups.

There were 25 cases in group A and 40 cases in group B. The ratio of stage Ⅰ+Ⅱ patients in group A (8/25, 32.0%) was significantly lower than that in group B (23/40, 57.5%) ( χ²=4.010, P=0.045), and there were no significant differences in the other clinicopathological characteristics between the groups. The median follow-up time was 35 months. The biochemical cure rate was 67.9% (38/56) and the recurrence rate was 18.5% (12/65). There were no significant differences in biochemical cure rate (63.6% vs 70.6%), recurrence rate (28.0% vs 12.5%) and progression-free survival [(46.29±3.21) months vs (61.94±3.58) months] between the groups.

For sporadic MTC patients, total thyroidectomy is not always necessary, and selective unilateral lobectomy is feasible.