中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (05): 398-401.

• 专题笔谈 • 上一篇    下一篇

甲状腺髓样癌诊治的若干问题

陈    曦   

  1. 上海交通大学医学院附属瑞金医院外科，上海200025
  • 出版日期:2011-05-01 发布日期:2011-05-30

  • Online:2011-05-01 Published:2011-05-30

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摘要：

甲状腺髓样癌来源于甲状腺滤泡旁细胞，约占甲状腺癌的4%，其中25%为多发性内分泌肿瘤2型相关的遗传性病变，主要包括2a型、2b型和家族性甲状腺髓样癌。降钙素是甲状腺髓样癌特异的肿瘤指标，提示肿瘤发生、残留或复发，而其翻倍时间与预后相关。全甲状腺切除及颈部淋巴结清扫是根治甲状腺髓样癌的唯一希望。基因测序技术的应用使多发性内分泌肿瘤2型相关的甲状腺髓样癌家系病人通过预防性手术而获益。

关键词: 甲状腺髓样癌, 降钙素, 全甲状腺切除术, 基因测序

Abstract:

Discussion in the diagnosis and treatment of medullary thyroid cancer        CHEN Xi. Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine，Shanghai 200025，China
Abstract    Medullary thyroid cancer (MTC) originates from parafollicular C cells of the thyroid gland, and accounts for about 4% of thyroid cancer cases. MTC presents as part of an autosomal dominant inherited disorder related to multiple endocrine tumor type 2 (MEN-2) in about 20%～25% of cases, including MEN-2a, MEN-2b and family MTC, and as a sporadic tumor in the remainder. Calcitonin is a specific tumor marker of MTC, which indicates the tumor onset, residue and recurrence. Calcitonin doubling-time is related to the prognosis. The only possible to cure MTC is total thyroidectomy and lymph node dissection, and the prophylactic surgery benefits the MEN-2 related patients.

Key words: medullary thyroid carcinoma, calcitonin, total thyroidectomy, gene sequencing