甲状腺髓样癌术后随访管理

Management of follow-up of patients with MTC after operation

甲状腺髓样癌(MTC)中75%为散发病例,25%为遗传性疾病。绝大多数遗传性MTC为多发性内分泌肿瘤2型相关病变。降钙素水平升高是诊断MTC的敏感指标。手术是惟一可能治愈MTC的方法,全甲状腺切除术和颈淋巴清扫术是根治甲状腺髓样癌的重要环节。这些因素决定了该类病人术后的随访管理内容和水平,要定期复查降钙素和癌胚抗原水平,其倍增时间是预后关键因素,增高的病人进行多器官影像学检查,制定综合性治疗方案。

Medullary thyroid cancer(MTC)accounts for approximately 4%of all thyroid cancers.Seventy-five percent of them are sporadic cases and 25%are hereditary.Most of them are related to multiple endocrine neoplasia type 2.Calcitonin is a sensitive mark of MTCand surgery plays the most important role in the treatment of MTC.Total thyroidectomy with regional lymph node dissection is the first choice.The factors would decide the contents and quality of follow-up of those patients with MTC after operation.The periodical follow-up of calcitonin and CEA is very important and double-time is the important factor of prognosis.MDT is necessary to the advanced patients.