甲状腺微小乳头状癌的外科治疗进展与争议

Surgical treatment of thyroid micropapillary carcinoma is controversial

近年来,甲状腺微小乳头状癌(PTMC)检出率呈持续增高,尽管多数PTMC生物学行为呈惰性,预后良好,但仍有部分病例存在侵袭性及复发风险,使得PTMC诊疗规范成为临床的关注焦点。国内外不同指南在PTMC的诊疗方面还存在一定争议,但规范的外科手术是PTMC的首选治疗手段,对于PTMC的非手术观察策略应谨慎推广。术后意外甲状腺微小乳头状癌(PIPTMC),呈高侵袭性者,应再次手术治疗。最新专家共识,为PTMC提供更加合理规范的诊治方案,从而制定精准、个体化的手术方式。

In recent years,the detection rate of thyroid small papillary carcinoma(PTMC)has been continuously increasing.Although most PTMC biological behaviors are inert and the prognosis is good,some cases still have the risk of invasion and recurrence,making PTMC diagnosis and treatment standard become the focus of clinical attention.Different guidelines at home and abroad still have some disputes on the diagnosis and treatment of PTMC,but standard surgery is the preferred treatment for PTMC,and non-surgical observation strategies of PTMC should be carefully promoted.Patients with an unexpected small papillary carcinoma of the thyroid(PIPTMC)that is highly invasive after surgery should be treated again.The latest expert consensus is to provide PTMC with more reasonable and standardized diagnosis and treatment plans,so as to develop accurate and individualized surgical methods.