目的总结空军飞行人员中甲状腺癌的病例特点,分析治疗方法以及效果,探讨医学鉴定经验,为不断完善飞行人员体格检查标准提供一定的参考依据。方法回顾性分析2010年1月—2016年1月间11例因甲状腺癌于空军总医院住院的飞行人员的病例特点、治疗效果、飞行相关医学鉴定结论及随访结果。结果 11例甲状腺癌患者均因体检时行超声检查发现。患者发病年龄25~49岁不等,所有患者均否认甲状腺疾病家族史。就甲状腺癌病灶本身情况而言,甲状腺癌肿位置1例呈多灶性同时累及双侧叶和峡部,2例为2处癌肿分别累及左叶、右叶及峡部。癌肿最大径范围0.3~4 cm,5例伴钙化,6例无钙化。2例发病时即发现存在淋巴结转移,1例术后复查发现淋巴结转移,8例甲状腺癌未累及淋巴结。治疗上,11例患者中,1例因甲状腺广泛受累行甲状腺全切术,其余10例均行甲状腺癌根治术保留部分甲状腺组织。3例术后即接受放射性I~(131)治疗,1例因术后定期复查发现淋巴结转移而行I131治疗,7例未行该治疗。11例患者中,10例术后均行TSH抑制治疗,TSH范围在0.041~0.4 m IU/L,1例未行TSH抑制治疗。除1例术后8个月出现淋巴结转移复发,余10例术后随访1~5年均未出现复发。最终,6例给予飞行合格结论,5例因合并淋巴结转移或出现手术并发症而不合格。结论我国空军飞行人员中甲状腺癌的发病年龄、癌肿大小、是否伴钙化、是否存在淋巴结受累以及手术术式、术后I131及TSH抑制等辅助治疗上存在一定差异,约半数患者经医学鉴定飞行合格。飞行人员应定期行甲状腺超声检查,发现甲状腺结节应予以重视,对于存在甲状腺癌高危因素者应密切随访、积极行穿刺活检,确诊后尽早行手术,结合术后辅助治疗,以期做到早发现、早诊断、早治疗,减少飞行人员停飞率。 Objective To summarize the characteristics of thyroid cancer in Air Force pilots, analyze the treatment methods and effects, discuss the experience of medical appraisal, and provide some reference for continuously improving the medical examination standards of pilots. Methods A retrospective analysis of 11 cases of pilots with thyroid cancer who were hospitalized in the Air Force General Hospital between January 2010 and January 2016 was conducted to investigate the characteristics of the cases, the treatment effect, the conclusion of the flight-related medical evaluation and the follow-up results. Results 11 cases of thyroid cancer patients were examined by ultrasound during the examination. Patients with age ranged from 25 to 49 years old, all patients have denied a family history of thyroid disease. Thyroid cancer lesions in terms of their own situation, the location of thyroid cancer in 1 case was multifocal involved both bilateral lobes and isthmus, 2 cases of 2 cancer involving the left lobe, right lobe and isthmus. The maximum diameter of cancer range 0.3 ~ 4 cm, 5 cases with calcification, 6 cases without calcification. Two cases were found to have lymph node metastasis at the time of onset, one case had lymph node metastasis after operation, and 8 cases had no lymph node involvement in thyroid cancer. Treatment, 11 patients, 1 case of extensive thyroid involvement of total thyroidectomy, the remaining 10 cases underwent radical thyroidectomy to retain part of the thyroid tissue. Three patients received radioactive I ~ (131) postoperatively, and one patient underwent I131 treatment because of regular postoperative recurrence. Seven patients did not receive the treatment. Of the 11 patients, TSH inhibition was performed in 10 patients after operation, with TSH ranged from 0.041 to 0.4 m IU / L and no TSH suppression treatment was performed in 1 patient. In addition to a case of recurrence of lymph node metastasis 8 months after surgery, the remaining 10 cases were followed up for 1 to 5 years were not recurrence. Finally, 6 cases were given the flight qualified conclusion, 5 cases failed due to the combined lymph node metastasis or surgical complications. Conclusions The age of onset of thyroid cancer, the size of the cancer, the presence or absence of calcification, the presence or absence of lymph node involvement, and the surgical procedures, postoperative I131 and TSH suppression have some differences in the treatment of thyroid cancer in China’s Air Force pilots. About half of the patients have been medically identified as flying qualified. Pilots should regularly go through thyroid ultrasound examination and found that thyroid nodules should be taken seriously, for the presence of thyroid cancer risk factors should be followed up, positive biopsy, confirmed as soon as possible after surgery, combined with postoperative adjuvant therapy in order to achieve early detection , Early diagnosis and early treatment, to reduce the flight personnel flying rate.