甲状腺髓样癌（MTC）的全程管理高度依赖血清降钙素（Ctn）与癌胚抗原（CEA）的动态监测。在诊疗阶段，应确立“以 Ctn为主导、CEA协同、影像学与基因检测为补充”的综合诊断策略，为手术范围确定、转移风险评估及个体化干预提供重要循证依据。在术后随访中，Ctn倍增时间（DT）＜6 个月者，其 10 年生存率仅约 25%；而CEA DT的缩短则提示内脏转移风险增加。Ctn 与 CEA 的协同监测体系贯穿 MTC 的诊断、手术与预后管理全周期，是优化个体化治疗策略的重要基石。
Abstract
The whole-course management of medullary thyroid carcinoma (MTC) relies heavily on dynamic monitoring of serum calcitonin (Ctn) and carcinoembryonic antigen (CEA). During the diagnostic and therapeutic stages, a comprehensive strategy of “Ctn as the primary indicator, CEA as a complementary marker, with imaging and genetic testing as supplements” should be established, providing crucial evidence for determining the extent of surgery, assessing metastatic risk, and guiding individualized interventions. In postoperative follow-up, patients with a Ctn doubling time (DT) of less than 6 months have a 10-year survival rate of only approximately 25%, while a shortened CEA DT indicates an increased risk of visceral metastasis. The synergistic monitoring system of Ctn and CEA runs through the entire process of diagnosis, surgery, and prognostic management of MTC, and serves as a cornerstone for optimizing individualized therapeutic strategies.
关键词
甲状腺髓样癌 /
降钙素 /
癌胚抗原 /
动态监测 /
临床决策 /
全程管理
Key words
medullary thyroid carcinoma /
calcitonin /
carcinoembryonic antigen /
dynamic monitoring /
clinical decision-making /
whole-course management
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