甲状腺微小乳头状癌:选择手术还是非手术主动监测?

Papillary Thyroid Microcarcinoma:Surgery or Active Surveillance?

甲状腺癌发病率逐年增加,新增病例中绝大多数为甲状腺乳头状癌,其中约一半为甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)。外科治疗是甲状腺乳头状癌的主要治疗手段。甲状腺乳头状癌因其可治疗性和相对较好的生存率而被称为"良癌"或者"惰性癌"。特别是PTMC,绝大多数并不危及患者生命,因此,在过去的十年中出现了一种替代的管理方法,即"主动监测(active surveillance,AS)",也有研究者称之为"延迟或延迟手术",在监视过程中发现肿瘤进展就需要积极手术。外科手术和AS各有优缺点,特别是AS的实施,本文就PTMC实施AS作简要介绍,以供临床工作者参考。

The incidence of thyroid carcinoma is increasing year by year,and most of the new cases are papilla thyroid carcinoma,of which about half are papillary thyroid microcarcinoma(PTMC). Surgical treatment is the main treatment for thyroid papilla carcinoma. Thyroid papilla cancer is called good cancer or lazy cancer because of its treatability and relatively good survival. In particular,the majority of PTMC,does not endanger the lives of patients. Therefore,in the past decade,an alternative management method has emerged,namely active surveillance(AS) which is call delayed or delayed surgery by some researchers. Active surgery is needed to detect tumor progress in the course of monitoring. Surgery and AS,especially the implementation of AS,have their own advantages and disadvantages. This paper briefly introduces the implementation of AS in PTMC,which can be used as a reference for clinical workers.