远处转移甲状腺癌诊治值得关注的几个问题  

Issues about the diagnosis and treatment of distant metastatic thyroid cancer

作　　者：田文 王冰 TIAN Wen;WANG Bing(Department of Thyroid&Hernia Surgery,Medical Department of General Surgery,the First Medical Center of Chinese PLA General Hospital,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

出　　处：《中国实用外科杂志》2024年第6期615-618,624,共5页Chinese Journal of Practical Surgery

基　　金：北京市科技计划课题(No.Z141107002514102)。

摘　　要：远处转移甲状腺癌是目前甲状腺癌诊治中的重点及难点,须结合实验室检查、影像学检查、病理学及分子学诊断对颈部原发灶和远处转移灶进行全面系统的评估,经多学科讨论后决定诊治策略并实施规范有序的治疗。远处转移甲状腺癌的治疗策略重点是评估并确定颈部原发灶及远处转移灶的处理顺序及方式,应遵循优先处理危及生命或可能出现严重并发症的病灶的原则,治疗方式包括外科手术、内分泌治疗、131I治疗、靶向治疗、外照射治疗、新辅助治疗等。应根据治疗效果制定个体化随访方案,动态监控病情并适时调整治疗策略,以期最大程度提高病人生活质量,延长生存时间。Distant metastatic thyroid cancer is the key and difficult point in the diagnosis and treatment of thyroid cancer.It is necessary to conduct a comprehensive and systematic evaluation of the primary cervical lesion and distant metastatic lesion in combination with laboratory examination,imaging examination,pathology,and molecular diagnosis,and decide the diagnosis and treatment strategy and implement standardized and orderly treatment after multidisciplinary discussion.The treatment strategy of distant metastatic thyroid cancer focuses on evaluating and determining the order and mode of treatment of cervical primary lesions and distant metastases.It should follow the principle of prioritizing treatment of lesions that are life-threatening or may have serious complications.The treatment modalities include surgery,endocrine therapy,131I therapy,targeted therapy,external irradiation therapy,neoadjuvant therapy,etc.Individualized follow-up plan should be developed according to the treatment effect,dynamic monitoring of the disease and timely adjustment of treatment strategies,to maximize the quality of life and prolong the survival time of patients.

关 键 词：甲状腺癌 远处转移 多学科综合治疗协作组 

分 类 号：R6[医药卫生—外科学]