关键词: 甲状腺髓样癌, 影像学诊断, 基因检测, 手术策略, 多学科综合治疗协作组

Abstract:

Difficulties and countermeasures in the diagnosis and treatment of medullary thyroid carcinoma        ZHANG Hao, ZHANG Da-lin. Department of Thyroid Surgery，the First Hospital of China Medical University，Shenyang 110001，China
Corresponding author: ZHANG Hao，E-mail：haozhang@cmu.edu.cn
Abstract    Prognosis of medullary thyroid carcinoma（MTC） is worse，and occurrence of early metastasis is easy. Hereditary and sporadic MTC have different clinical characteristics and prognosis. The diagnostic value of ultrasound,CT,MRI and bone scintigraphy is special. Calcitonin（Ctn）is found to have diagnostic specificity，while carcinoembryonic antigen（CEA）is useful for evaluating disease progression. Whether hereditary or sporadic MTC，surgeons should pay attention to the subsequent genetic detection. Different surgical strategies are required for hereditary and sporadic MTC. Active surgery is necessary for patients with regional recurrence and nodal metastasis. Advanced progressive MTC could be treated by palliative surgery，external radiotherapy or systemic treatment with the tyrosine kinase inhibitor. Measurement of doubling times of serum Ctn and CEA can evaluate recurrence and metastasis after surgery.

Key words: medullary thyroid carcinoma；imaging diagnosis；genetic detection；surgical strategy；multidisciplinary , team