中国实用外科杂志

中国实用外科杂志

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甲状腺髓样癌靶向治疗

李    茵，李秋梨，郭朱明   

  1. 中山大学肿瘤防治中心头颈科  华南肿瘤学国家重点实验室  肿瘤医学协同创新中心，广东广州510060
  • 出版日期:2020-09-01 发布日期:2020-09-21

  • Online:2020-09-01 Published:2020-09-21

摘要： 甲状腺髓样癌侵袭性强，易发生淋巴结转移和远处转移，预后欠佳。其发病常表现为RET基因突变，M918T在所有突变中预后最差，提示临床上应早期重视甲状腺髓样癌的基因检测。对于晚期、进展性、无法切除的甲状腺髓样癌，靶向治疗占绝对主导地位。靶向药物的介入时间仍然是值得探讨的课题。随着凡德他尼、卡博替尼、安罗替尼、BLU－667、LOXO-292等靶向药物的不断涌现，在关注药物疗效的同时，需要把握毒副反应及病人生活质量之间的平衡。

关键词: 甲状腺髓样癌, 靶向治疗, 分子遗传学, 基因检测

Abstract: Targeted therapy of medullary thyroid carcinoma        LI Yin,LI Qiu-li, GUO Zhu-ming. Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center；State Key Laboratory of Oncology in South China；Collaborative Innovation Center of Cancer Medicine，Guangzhou 510060, China
Corresponding author: GUO Zhu-ming,E-mail：guozhm@
sysucc.org.cn
Abstract    Medullary thyroid carcinoma is highly aggressive，prone to lymph node metastasis and distant metastasis，and the prognosis is poor.Its incidence is often manifested as RET gene mutations.M918T has the worst prognosis among all mutations，suggesting that early clinical attention should be paid to genetic testing of medullary thyroid cancer. For advanced，progressive，and unresectable medullary thyroid cancer，targeted therapy is absolutely dominant.The intervention time of targeted drugs is still a topic worthy of discussion. With the continuous emergence of targeted drugs such as vandetanib，cabozantinib，anlotinib，BLU-667，LOXO-292，while paying attention to the efficacy of drugs，it is necessary to grasp the relationship between side effects and the quality of life of patients.

Key words: medullary thyroid carcinoma, targeted therapy, molecular genetics, genetic testing