积极监测：低风险甲状腺微小乳头状癌的一线治疗？

Active monitoring:first-line treatment of low-risk thyroid micropapillary carcinoma?

根据世界卫生组织标准,甲状腺乳头状癌中将直径≤10 mm的肿瘤称为甲状腺微小乳头状癌(PTMC)。随着超声的普及,PTMC的发病率逐年升高,但其对应的死亡率却变化不大。对于无淋巴结转移或远处转移的低风险PTMC患者而言,手术是否是他们的唯一选择?针对这类患者,考虑到其预后好,手术并发症影响大,国外有学者提出了一种新的非手术治疗方法-积极监测(AS),这在国际上引发了大家的热议。本文通过对大家的争议点进行梳理,希望给临床医生的治疗决策带来更好的参考。

According to the World Health Organization,papillarythyroid carcinoma not more than10 mm is called papillarythyroid microcarcinoma(PTMC). With the popularity of ultrasound,the incidence of PTMC increases year by year,but the corresponding mortality does not change much. Is surgery the only option for low-risk PTMC patients who are without lymph node metastasis or distant metastasis?In view of the good prognosis of such patients and the great influence of surgical complications,some foreign scholars have proposed a new non-surgical treatment method-active surveillance(AS),which has aroused heated discussion in the international community. By sorting out the controversial points,this paper hopes to provide better references for clinicians′ decisions.