妊娠对已知分化型甲状腺癌患者结局的影响

Effect of pregnancy on the outcome of patients with known differentiated thyroid cancer

分化型甲状腺癌(differentiated thyroid cancer,DTC)好发于女性患者,且育龄期女性发病率可达男性的4倍。但除少许报道妊娠导致DTC原发和转移病灶迅速进展或术后病灶持续外,妊娠对于DTC患者病情影响小。未治疗DTC妊娠患者通过监测可推迟手术时间;已治疗 DTC妊娠患者肿瘤复发和进展主要集中在本身复发风险高,特别是存在结构反应不全(structural incomplete response)的孕妇,而病情进展是本身病情发展还是妊娠所致,尚需进一步观察研究。

Differentiated thyroid cancer (DTC) is commonly seen in females, and the incidence rate of women of childbearing age is up to four times that of men. Overall, pregnancy has little impact on DTC patients, except in a few cases where pregnancy causes rapid progression of primary and metastatic lesions or persistence of post-operative lesions. For untreated pregnant patients with DTC, operation can be delayed by monitoring. For treated pregnant patients with DTC, tumor recurrence and progression are mainly seen in those with high risk of recurrence, especially with structural incomplete response. Whether the progression is caused by the development of the disease itself or pregnancy still needs further study.