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目的：通过190例分化型甲状腺癌手术治疗回顾性分析，旨在探讨分化型甲状腺癌的手术切除范围及颈部淋巴结清扫回顾。方法：选取1980年1月至1996年12月收治190例经手术、病理证实为分化型甲状腺癌，其中长期随访140例。结果：156例限于一侧腺叶内的肿瘤，行甲状腺腺叶、峡部切除术，随访102例，仅1例对侧腺叶出现癌复发。96例肿物直径大于1．5cm，并且颈部淋巴结无肿大者，行预防性颈淋巴结清扫，54例发现颈部淋巴结有转移灶。结论：为了降低复发率和避免并发症，甲状腺腺叶、峡部切除是理想的术式；对于原发肿瘤直径大于1．5cm，无论术前、术中是否触到肿大淋巴结，均需作改良颈淋巴结清扫；对临床颈淋巴结阳性者，应根据具体情况实施功能或传统颈淋巴结清扫术。
OBJECTIVE: To retrospectively analyze 190 cases of differentiated thyroid cancer and to explore the scope of surgical resection of differentiated thyroid cancer and review of cervical lymph node dissection. METHODS: From January 1980 to December 1996, 190 cases of differentiated thyroid carcinoma confirmed by surgery and pathology were enrolled. Long-term follow-up of 140 cases was performed. RESULTS: 156 cases were limited to tumors in one side of the gland and performed thyroid gland lobe and isthmectomy. 102 cases were followed up. Only 1 case had recurrence of cancer in the contralateral gland. Among 96 patients with tumors larger than 1.5 cm in diameter, and with no enlarged lymph nodes in the neck, prophylactic cervical lymph node dissection was performed and 54 lymph nodes with metastatic lesions were found in the neck. Conclusion: In order to reduce the recurrence rate and avoid complications, thyroid gland lobe and isthmus resection are ideal methods; for primary tumors larger than 1.5 cm in diameter, no matter whether the enlarged lymph nodes are touched before or during surgery, they need to be improved. Cervical lymph node dissection; for patients with positive cervical lymph nodes, functional or conventional cervical lymph node dissection should be performed according to specific conditions.