局部进展期甲状腺癌诊治中的关键问题  

Key issues in the diagnosis and management of locally advanced thyroid carcinoma

作　　者：田文 李兴睿[2] TIAN Wen;LI Xing-rui(Department of General Surgery,General Hospital of the People's Liberation Army(PLA),Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心普通外科医学部甲状腺(疝)外科,北京100853 [2]华中科技大学同济医学院附属同济医院甲状腺乳腺外科,湖北武汉430030

出　　处：《中国实用外科杂志》2023年第8期849-853,共5页Chinese Journal of Practical Surgery

基　　金：北京市科技计划课题(No.Z141107002514102)。

摘　　要：局部进展期甲状腺癌特征为侵犯颈部周围器官及组织结构,涉及甲状腺癌的各种病理学类型,手术切除仍是目前主要的治疗手段。随着新辅助靶向药物的应用,部分进展期肿瘤可获得降期手术,提高可切除率的同时也保留了周围器官的功能。此外,术前充分的影像学、病理学和基因诊断评估,多学科综合治疗协作组(MDT)讨论优化手术方案及个体化围手术期管理,以及术后强化的系统性辅助治疗策略,有助于疾病的控制和并发症的预防与应对,改善病人的生存质量及预后,提高综合疗效。Locally advanced thyroid carcinoma is characterized by the invasion of surrounding organs and tissues in the neck region and encompasses various pathological subtypes.Surgical resection remains the primary treatment modality at present.With the implementation of neoadjuvant targeted therapies,certain advanced tumors can undergo downstaging,thereby enhancing resectability rates while preserving the functionality of surrounding organs.In addition,sufficient preoperative imaging,comprehensive pathological and genetic diagnosis evaluation,multidisciplinary team(MDT)discussion to optimize the surgical plan and individualized perioperative management,as well as postoperative intensive systemic adjuvant therapy strategies are beneficial for disease control,complication prevention,patients'quality of life enhancement and the overall therapeutic outcome optimization.

关 键 词：局部进展期甲状腺癌 新辅助治疗 靶向治疗 多学科综合治疗协作组 

分 类 号：R6[医药卫生—外科学]