甲状旁腺癌补救手术的再思索  

The remedial surgery for parathyroid carcinoma

作　　者：胡亚[1] 廖泉[1] Hu Ya;Liao Quan(Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medicine Sciences&Peking Union Medical College,Beijing 100730,China)

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：《中华内分泌外科杂志》2022年第1期123-125,共3页Chinese Journal of Endocrine Surgery

基　　金：中国医学科学院临床与转化医学研究基金 (2020-I2M-C&T-B-029)。

摘　　要：甲状旁腺癌是一种少见的内分泌恶性肿瘤,大部分患者会面临肿瘤复发或转移,最后因高钙危象危及生命。目前尚缺乏针对甲状旁腺癌的放化疗辅助治疗措施,手术治疗仍是其主要的治疗手段。肿瘤局部切除术适用于甲状旁腺良性肿瘤,而甲状旁腺癌则推荐实施根治性手术,整块切除肿瘤、同侧甲状腺及周围组织。在没有发生远处转移的情况下,术前诊断甲状旁腺癌是非常困难的,大部分的甲状旁腺癌是通过术后病理诊断获得确诊。故对首次手术中未实施根治性切除的患者是否需立即进行补救手术,目前尚存在争议。本文根据近年来国内外文献,对甲状旁腺癌的手术方式和补救手术的必要性进行综述讨论,同时结合最新研究结果提出进一步探索的方向。The incidence of parathyroid carcinoma(PC)is low while the long-term outcome is poor in most cases.Most patients with PC suffered from relapse or metastasis,and the main reason of mortality is hypercalcemia and related complications.Surgery is the main therapy for PC.Local resection is suitable for benign lesion while radical resection including parathyroid lesion,ipsilateral thyroid lobe and surrounding soft tissue is suggested for parathyroid carcinoma.It is still difficult to identify the malignancy among parathyroid neoplasm before operation without distant metastasis.Parathyroid carcinoma was diagnosed after first surgery of local resection in most patients with histopathological evaluation.The significance of remedial surgery for this situation was still indeterminate.In this review,the different opinions about the management of PC were introduced and several suggestions were presented based on the literatures.

关 键 词：甲状旁腺癌 补救手术 

分 类 号：R653[医药卫生—外科学] R736.2[医药卫生—临床医学]