甲状腺髓样癌的诊治现状

doi:10.16139/j.1007-9610.2022.03.019

摘要/Abstract

摘要：

甲状腺髓样癌（medullary thyroid carcinoma,MTC）是起源于甲状腺滤泡旁细胞（C细胞）的少见特殊甲状腺癌,属于侵袭性神经内分泌肿瘤。降钙素和癌胚抗原仍是目前常用的标志物,其升高能可靠诊断MTC。其术前测定值,术后倍增时间对手术淋巴结清扫范围、预后判断有重要意义。手术治疗建议甲状腺全切除和中央区淋巴结清扫,必要时侧区清扫。推荐常规进行RET基因检测。对无法手术或远处转移病人,考虑靶向治疗。仍需加强MTC病理机制研究。

关键词: 甲状腺髓样癌, 降钙素, 外科治疗

Abstract:

Medullary thyroid carcinoma (MTC) arising from the parafollicular cell (C cell) of the thyroid gland, is an aggressive neuroendocrine tumor and a special rare thyroid malignancy. Calcitonin and carcinoembryonic antigen are still commonly used markers now, whose elevation can reliably diagnose MTC. The preoperative value and postoperative doubling time of these markers are of great significance for range of lymph node dissection and evaluation of prognosis. It is recommended that total thyroidectomy and central lymph node dissection would be needed and lateral lymph node dissection would be added when necessary. Routine detection of RET gene is recommended. Targeted therapy is considered for non-operable patients or the patients with distant metastasis. The pathological mechanism of MTC still needs to be paid attention.

Key words: Medullary thyroid carcinoma, Calcitonin, Surgical treatment

中图分类号:

R736.1

陈承坤综述, 郭伯敏, 邓先兆, 伍波, 樊友本审校. 甲状腺髓样癌的诊治现状[J]. 外科理论与实践, 2022, 27(03): 276-280.

CHEN Chengkun, GUO Bomin, DENG Xianzhao, WU Bo, FAN Youben. Diagnosis and treatment of medullary thyroid carcinoma-an update[J]. Journal of Surgery Concepts & Practice, 2022, 27(03): 276-280.

图/表 1

参考文献 35

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风险	密码子突变	手术时间	手术方式（TT±CND）
最高风险	M918TA883F^a）	<1岁	无LNM且PIS或PAT,加CND
高风险	C634A883F	<5岁	Ctn>40 ng/L或LNM,加CND
中风险	其他突变	≥5岁	Ctn↑或LNM,加CND