甲状旁腺癌的外科诊治进展

Progress in Diagnosis and Surgical Treatment of Parathyroid Carcinoma

甲状旁腺癌(parathyroid carcinoma, PC)是一种罕见内分泌恶性肿瘤,其发病虽目前位于恶性肿瘤发生末位(占所有癌症比例的0.005%),但其一旦发生如果因为临床医师经验不足而造成诊治拖延与决策失误,便可能会给患者带来严重而不可逆的身体危害,故PC的临床诊断以及治疗方式有其重要研究价值。本文将甲状旁腺癌外科诊治过程的关键总结为“四不”,即诊前不忽视(应对PC的发生引起重视),诊中不单一(诊断技术选择不单一),术中不吝惜(绝不吝惜PC有可能侵犯的组织),才有可能最后做到术后不复发(实现不给患者带来二次手术及痛苦的希望)。笔者也将从此四个维度对甲状旁腺癌的外科诊治进展进行叙述,并对其综合治疗发展的前景进行展望。

Parathyroid carcinoma (PC) is a rare endocrine malignant tumor. Although its incidence is at the end of malignant tumors (accounting for 0.005%), however, once it happens, if the diagnosis and treatment delay and decision-making errors are caused by the lack of clinicians’ experience, it may bring serious and irreversible physical harm to patients. Therefore, the clinical diagnosis and treatment of PC have important research value. In this paper, the key to the diagnosis and surgical treatment of parathyroid cancer is summarized as “four nos”, that is, do not ignore before diagnosis (pay attention to the occurrence of PC), do not single during diagnosis (the choice of diagnostic technology is not single), and do not spare during operation (do not spare the tissues that may be invaded by PC), so that it is possible to avoid recurrence after operation (realize the hope of not bringing secondary operation and pain to patients). The author will also describe the progress of diagnosis and surgical treatment of parathyroid carcinoma from these four dimensions, and pro-spect its comprehensive treatment.