成人低危型甲状腺微小乳头状癌临床主动监测研究进展  

Progress in active surveillance for adult low-risk papillary thyroid microcarcinoma

作　　者：刘俊松[1] 许崇文[1] 姚小宝[1] 赵瑞敏[1] 张少强[1] LIU Junsong;XU Chongwen;YAO Xiaobao;ZHAO Ruimin;ZHANG Shaoqiang(Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Xi'an Jiaotong University,Clinical Research Center for Thyroid Diseases of Shaanxi Province,Xi'an,710061,China)

机构地区：[1]西安交通大学第一附属医院耳鼻咽喉头颈外科、陕西省甲状腺疾病临床医学研究中心,西安710061

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第2期150-156,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：陕西省自然科学基础研究计划(No:2021JQ-405);陕西省甲状腺疾病临床医学研究中心经费(No:2017LCZX-03)。

摘　　要：甲状腺微小乳头状癌(PTMC)的发病率迅速增长,然而,流行病学和尸检研究结果显示,低危型PTMC(LR-PTMC)的人群患病率很高,但致死率很低,LR-PTMC存在一定程度的过度诊断和过度治疗。对LR-PTMC采取主动监测而非立即手术,70%以上的病灶在临床观察中保持稳定或缩小,于是,世界多个学术团体在临床诊疗指南中,将主动监测作为LR-PTMC的推荐方案之一。然而,甲状腺微小癌并不等于低危癌,主动监测的实施需要严格掌握适应证,并充分考虑人群特征,以保证患者的最大获益。本文就成人LR-PTMC临床主动监测的研究进展作一综述。The incidence of papillary thyroid microcarcinoma(PTMC) increases rapidly.However,epidemiological and autopsy studies show that the prevalence of low-risk papillary thyroid microcarcinoma(LR-PTMC) is very high,but the mortality is very low.There is over-diagnosis and over-treatment for LR-PTMC.Active surveillance(AS) was adopted for LR-PTMCs instead of immediate surgery,and more than 70% of the lesions remained stable or shrank in clinical observation.Therefore,AS is recommended for LR-PTMCs in clinical guidelines of several academic organizations around the world.However,PTMC is not equal to low-risk cancer.The implementation of AS strategy requires a strict grasp of indications and full consideration of population characteristics to ensure the maximum benefit of patients.This paper summarizes the present clinical progress of active surveillance for adult LR-PTMC.

关 键 词：甲状腺微小乳头状癌 主动监测 过度诊断 尸检研究 

分 类 号：R736.1[医药卫生—肿瘤]