ABSTRACT
Objective To investigate the biological characteristics of papillary thyroid carcinoma(PTC) and to discuss its surgical method.Methods 221 patients of PTC underwent total thyroidectomy and conventional central lymph node dissection from Jul.2009 to Feb.2011 in Department of Thyroid Surgery in the First Hospital of Jilin University.Their clinical data were retrospectively analyzed.Results There was no permanent iatrogenic injury of recurrent laryngeal nerve.Only one patient had permanent hypoparathyroidism.Postoperative pathological results showed that bilateral cancer was found in 69 cases(31.2％).Thyroid membrane invasion was found in 143 cases(64.7％),in which the invasion rate of bilateral cancer was 68.1％ (47/69).Central cervical lymph node metastasis was found in 95 cases(43％),in which central cervical lymph node metastasis rate of bilateral cancer was 46.4％ (32/69),central cervical lymph node metastasis rate of unilateral cancer was 41.5 ％ (63/152),central cervical lymph node metastasis rate of thyroid membrane invasion was 49.7％ (71/143).Thyroid membrane invasion or cervical lymph node metastasis rate in all cases was 75.6％ (167/221).There were 42 cases who were found with suspicious unilateral cancer before surgery but proved to have bilateral PTC by postoperative pathological diagnosis(60.9％).Conclusions Most PTC often occurs bilaterally and the ratio of central cervical lymph node metastasis is very high.We suggest that most patients with PTC should undergo total thyroidectomy,conventional central lymph node dissection,and combine with postoperative Ⅰ131 and hormonal treatment.