甲状腺微小乳头状癌主动监测的研究进展

Research progress in active surveillance for papillary thyroid microcarcinoma

随着高分辨率超声及细针穿刺活检技术的普及, 越来越多的甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)被诊断并接受甲状腺切除及术后碘放射治疗, 然而大多数PTMC患者手术时并无临床症状, 且其疾病进展较慢。因此对PTMC是否存在过度诊断和过度治疗一直存在争议。部分学者建议可把主动监测(active surveillance, AS)作为部分PTMC的一种有效的处置方式。然而临床也不乏PTMC发现时即出现淋巴结转移甚至远处转移的报道, 且AS与肿瘤早治原则相悖。因此, AS能否成为PTMC一种合理选择仍存在争议。本文就PTMC的AS相关研究进展进行综述。

With the widespread adoption of high-resolution ultrasound and fine needle aspiration biopsy(FNAB)techniques,an increasing number of cases of papillary thyroid microcarcinoma(PTMC)are being diagnosed and treated with thyroidectomy and postoperative iodine radiation therapy.However,the majority of PTMC patients do not exhibit clinical symptoms at the time of surgery,and the disease progresses slowly.Therefore,there is ongoing debate regarding the potential overdiagnosis and overtreatment of PTMC.Some scholars suggest that active surveillance(AS)could be an effective management strategy for certain PTMC cases.Nevertheless,there are also reports of PTMC cases presenting with lymph node metastases or even distant metastases at the time of discovery,which contradicts the principle of early treatment of tumors.Hence,whether AS can be considered a reasonable option for PTMC remains controversial.This article provides an overview of the current research progress on AS for PTMC.