中国实用外科杂志

中国实用外科杂志

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散发性甲状腺髓样癌术式选择及预后分析

张    浩，秦    元   

  1. 中国医科大学附属第一医院甲状腺外科，辽宁沈阳110001
  • 出版日期:2020-09-01 发布日期:2020-09-21

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

摘要： 散发性甲状腺髓样癌是甲状腺髓样癌的主要类型，尽管临床少见，但预后较差。手术是治疗散甲状腺发性髓样癌的主要手段，不规范的手术会导致肿瘤和转移淋巴结残留，增加复发风险，降低治愈率和存活率。全甲状腺切除和双侧中央区淋巴结清扫及治疗性颈侧区淋巴结清扫是治疗散发性甲状腺髓样癌的主要手术方式，在无明确影像学证据情况下，不推荐预防性颈侧区淋巴结清扫。年龄、肿瘤大小、淋巴结转移、腺外侵袭、远处转移、手术方式、RET基因突变、血清降钙素和CEA水平是影响散发性甲状腺髓样癌预后的危险因素。

关键词: 甲状腺髓样癌, 散发性髓样癌, 手术指征, 预后

Abstract:

Surgical selection and prognostic analysis of sporadic thyroid medullary carcinoma        ZHANG Hao, QIN Yuan. 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    Sporadic medullary thyroid carcinoma is the main type of medullary thyroid carcinoma. Although it is rare in clinical practice，the prognosis is poor. Surgery is the main method for the treatment of sporadic medullary thyroid carcinoma. Irregular surgery can lead to residual tumors and metastatic lymph nodes，increase the risk of recurrence，and reduce the cure rate and survival rate. Total thyroidectomy，bilateral central lymph node dissection and therapeutic lateral lymph node dissection are the main surgical methods for the treatment of sporadic thyroid medullary carcinoma. Prophylactic lateral lymph node dissection is not recommended in the absence of clear imaging evidence. Age，tumor size，lymph node metastasis，extrathyroid invasion，distant metastasis，surgical method, RET gene mutation，serum calcitonin and CEA levels are risk factors affecting the prognosis of sporadic thyroid medullary carcinoma.

Key words: medullary thyroid carcinoma, sporadic medullary thyroid carcinoma, surgical indication, prognostic analysis