遗传性和散发性甲状腺髓样癌的临床特点  

Clinical Characteristics of Hereditary and Sporadic Medullary Thyroid Carcinoma

作　　者：徐徕[1] 赵玉沛[1] 王维斌[1] 张太平[1] 廖泉[1] 陈革[1] 周立[1] 舒红[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院基本外科,北京100730

出　　处：《中国医学科学院学报》2012年第4期401-404,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨遗传性甲状腺髓样癌(HMTC)和散发性甲状腺髓样癌(SMTC)的临床病理特征。方法回顾性分析1980年7月至2011年5月期间北京协和医院收治的78例甲状腺髓样癌患者的临床资料,将其分为HMTC和SMTC两组,比较两组的临床病理特征及预后。结果 78例甲状腺髓样癌中,23例(29.5%)为HMTC,55例(70.5%)为SMTC。HMTC组发病年龄明显小于SMTC组(P<0.01),且术前及术后降钙素水平明显低于SMTC组(P<0.01)。与SMTC组相比,HMTC组肿瘤直径更小(P<0.05),肿瘤多灶性的比例更高(P<0.05)。HMTC组仅1例患者于术后314.7个月死于多发骨转移,10年总生存率明显高于SMTC组(P<0.05)。结论 HMTC患者的预后明显优于SMTC患者。Objective To study the clinical characteristics and outcomes of the hereditary medullary thyroid carcinoma （HMTC） and the sporadic medullary thyroid carcinoma （SMTC）. Methods The clinical data of 78 patients with medullary thyroid carcinoma who underwent surgery in our hospital between July 1980 and May 2011 were retrospectively analyzed. Results Of these 78 patients, there were 23 HMTC cases and 55 SMTC cases. The HMTC group was significantly younger age of onset [ （36.4 ± 13.5） years vs. （46.6± 11.2） years, P 〈 0.01 ] and a lower pre/post-operative serum calcitonin levels [ （850.4 ± 110.20） ng/L vs. （1450.4±118.3） ng/L, P〈0.01 and （410.8±133.2） ng/Lvs. （1585.4±129.5） ng/L, P〈0.01] than the SMTC group. In addition, the mean tumor diameter was also significantly smaller in the HMTC group （14. 3 mm vs. 21.0 mm in SMTC group, P 〈 0.05）. Tumor multifocality was Seen in a significantly higher proportion of HMTC cases compared with the SMTC cases （56.6% vs. 29.1% , P 〈 0.05 ）. The overall 10- year survival was 100% in HMTC group and 80.2% in SMTC group （P 〈 0.05）. Conclusion HMTC has a better prognosis than SMTC.

关 键 词：甲状腺肿瘤 甲状腺髓样癌 遗传型 2型多发内分泌肿瘤 

分 类 号：R6[医药卫生—外科学]