甲状腺髓样癌诊治现状及热点问题思考
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摘要
甲状腺癌为头颈部最常见的恶性肿瘤,近年来发病率呈上升的趋势。甲状腺髓样癌(medullary thyroid carcinoma,MTC)恶性程度位于甲状腺未分化癌与分化型甲状腺癌之间,具有早期侵犯区域淋巴结和向肺、骨等远处转移的倾向,预后相对较差。外科手术是根治甲状腺髓样癌的最佳选择,国内临床实践中,对于外科手术切除范围、颈部淋巴结清扫指征及血清降钙素在诊治过程中的意义等问题上仍然存在争议与分歧,本文将髓样癌国内诊治现状进行总结并对争议问题提出建议。
引文
[1] Wells SA Jr,Asa SL,Dralle H,et al.Revised American thyroid association guidelines for the management of medullary thyroid carcinoma [J].Thyroid,2015,25(6):567- 610.
[2] Raue F,Dralle H,Machens A,et al.Long-term survivorship in multiple endocrine neoplasia type 2B diagnosed before and in the new millennium [J].J Clin Endocrinol Metab,2018,103(1):235-243.
[3] 中华医学会内分泌学分会,中华医学会外科学分会,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南 [J].中国肿瘤临床,2012,39(17):1249-1272.
[4] Elisei R,Bottici V,Luchetti F,et al.Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer:experience in 10,864 patients with nodular thyroid disorders [J].J Clin Endocrinol Metab,2004,89(1):163-168.
[5] Niederle B.Screening for medullary carcinoma of the thyroid [J].Br J Surg,2014,101(13):1625-1626.
[6] Zhou Q,Yue S,Cheng Y,et al.Clinical and pathological analysis of 19 cases of medullary thyroid carcinoma without an increase in calcitonin [J].Exp Toxicol Pathol,2017,69(8):575-579.
[7] Tisell LE,Dilley WG,Wells SA.Progression of postoperative residual medullary thyroid carcinoma as monitored by plasma calcitonin levels [J].Surgery,1996,119(1):34-39.
[8] Barbet J,Campion L,Kraeberbodéré F,et al.Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling-times in patients with medullary thyroid carcinoma [J].J Clin Endocrinol Metab,2005,90(11):6077- 6084.
[9] Akenostuart N,Croyle M,Knauf JA,et al.The RET kinase inhibitor NVP-AST487 blocks growth and calcitonin gene expression through distinct mechanisms in medullary thyroid cancer cells [J].Cancer Res,2007,67(14):6956- 6964.
[10] Kurzrock R,Atkins J,Wheler J,et al.Tumor marker and measurement fluctuations may not reflect treatment efficacy in patients with medullary thyroid carcinoma on long-term RET inhibitor therapy [J].Ann Oncol,2013,24(9):2256-2261.
[11] 王军轶,张彬,鄢丹桂,等.73例初治甲状腺髓样癌术式探讨 [J].中国肿瘤临床,2012,39(7):410- 413.
[12] 刘微微,邓先兆,樊友本,等.散发性甲状腺髓样癌规范与非规范手术的效果观察 [J].中国普外基础与临床杂志,2014(11):1408-1412.
[13] Jasim S,Ying AK,Waguespack SG,et al.Multiple endocrine neoplasia type 2B with a RET proto-oncogene A883F mutation displays a more indolent form of medullary thyroid carcinoma compared with a RET M918T mutation [J].Thyroid,2011,21(2):189-192.
[14] Bugalho MJ,Madureira D,Domingues R,et al.Medullary thyroid carcinoma preferentially secreting procalcitonin [J].Thyroid,2014,24(7):1190-1191.
[15] 鄢丹桂,张彬,李正江,等.甲状腺髓样癌颈部淋巴转移规律的临床研究 [J].中华耳鼻咽喉头颈外科杂志,2015,50(4):290-294.
[16] 张再兴,李正江,唐平章,等.甲状腺髓样癌的外科治疗及预后分析 [J].中华耳鼻咽喉头颈外科杂志,2011,46(3):209-213.
[17] 张相民,蓝小林,李荣,等.甲状腺髓样癌17例临床分析 [J].中华实用诊断与治疗杂志,2013,27(10):1032-1033.
[18] Hirsch D,Twito O,Levy S,et al.Temporal trends in the presentation,treatment,and outcome of medullary thyroid carcinoma:an Israeli multicenter study [J].Thyroid.2018,28(3):369-376.
[19] Pillarisetty VG,Katz SC,Ghossein RA,et al.Micromedullary thyroid cancer:how micro is truly micro?[J].Ann Surg Oncol,2009,16(10):2875-2881.
[20] Kazaure HS,Roman SA,Sosa JA.Medullary thyroid microcarcinoma:a population-level analysis of 310 patients [J].Cancer,2012,118(3):620- 627.
[21] Beressi N,Campos JM,Beressi JP,et al.Sporadic medullary microcarcinoma of the thyroid:a retrospective analysis of eighty cases [J].Thyroid,1998,8(11):1039-1044.
[22] Peix JL,Braun P,Saadat M,et al.Occult micro medullary thyroid carcinoma:therapeutic strategy and follow-up [J].World J Surg,2000,24(11):1373-1376.
[23] Hamy A,Pessaux P,Mirallié E,et al.Central neck dissection in the management of sporadic medullary thyroid microcarcinoma [J].Eur J Surg Oncol,2005,31(7):774- 777.
[24] Kim JH,Pyo JS,Cho WJ.Clinicopathological significance and prognosis of medullary thyroid microcarcinoma:a meta-analysis [J].World J Surg,2017,41(10):2551-2558.
[2] Raue F,Dralle H,Machens A,et al.Long-term survivorship in multiple endocrine neoplasia type 2B diagnosed before and in the new millennium [J].J Clin Endocrinol Metab,2018,103(1):235-243.
[3] 中华医学会内分泌学分会,中华医学会外科学分会,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南 [J].中国肿瘤临床,2012,39(17):1249-1272.
[4] Elisei R,Bottici V,Luchetti F,et al.Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer:experience in 10,864 patients with nodular thyroid disorders [J].J Clin Endocrinol Metab,2004,89(1):163-168.
[5] Niederle B.Screening for medullary carcinoma of the thyroid [J].Br J Surg,2014,101(13):1625-1626.
[6] Zhou Q,Yue S,Cheng Y,et al.Clinical and pathological analysis of 19 cases of medullary thyroid carcinoma without an increase in calcitonin [J].Exp Toxicol Pathol,2017,69(8):575-579.
[7] Tisell LE,Dilley WG,Wells SA.Progression of postoperative residual medullary thyroid carcinoma as monitored by plasma calcitonin levels [J].Surgery,1996,119(1):34-39.
[8] Barbet J,Campion L,Kraeberbodéré F,et al.Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling-times in patients with medullary thyroid carcinoma [J].J Clin Endocrinol Metab,2005,90(11):6077- 6084.
[9] Akenostuart N,Croyle M,Knauf JA,et al.The RET kinase inhibitor NVP-AST487 blocks growth and calcitonin gene expression through distinct mechanisms in medullary thyroid cancer cells [J].Cancer Res,2007,67(14):6956- 6964.
[10] Kurzrock R,Atkins J,Wheler J,et al.Tumor marker and measurement fluctuations may not reflect treatment efficacy in patients with medullary thyroid carcinoma on long-term RET inhibitor therapy [J].Ann Oncol,2013,24(9):2256-2261.
[11] 王军轶,张彬,鄢丹桂,等.73例初治甲状腺髓样癌术式探讨 [J].中国肿瘤临床,2012,39(7):410- 413.
[12] 刘微微,邓先兆,樊友本,等.散发性甲状腺髓样癌规范与非规范手术的效果观察 [J].中国普外基础与临床杂志,2014(11):1408-1412.
[13] Jasim S,Ying AK,Waguespack SG,et al.Multiple endocrine neoplasia type 2B with a RET proto-oncogene A883F mutation displays a more indolent form of medullary thyroid carcinoma compared with a RET M918T mutation [J].Thyroid,2011,21(2):189-192.
[14] Bugalho MJ,Madureira D,Domingues R,et al.Medullary thyroid carcinoma preferentially secreting procalcitonin [J].Thyroid,2014,24(7):1190-1191.
[15] 鄢丹桂,张彬,李正江,等.甲状腺髓样癌颈部淋巴转移规律的临床研究 [J].中华耳鼻咽喉头颈外科杂志,2015,50(4):290-294.
[16] 张再兴,李正江,唐平章,等.甲状腺髓样癌的外科治疗及预后分析 [J].中华耳鼻咽喉头颈外科杂志,2011,46(3):209-213.
[17] 张相民,蓝小林,李荣,等.甲状腺髓样癌17例临床分析 [J].中华实用诊断与治疗杂志,2013,27(10):1032-1033.
[18] Hirsch D,Twito O,Levy S,et al.Temporal trends in the presentation,treatment,and outcome of medullary thyroid carcinoma:an Israeli multicenter study [J].Thyroid.2018,28(3):369-376.
[19] Pillarisetty VG,Katz SC,Ghossein RA,et al.Micromedullary thyroid cancer:how micro is truly micro?[J].Ann Surg Oncol,2009,16(10):2875-2881.
[20] Kazaure HS,Roman SA,Sosa JA.Medullary thyroid microcarcinoma:a population-level analysis of 310 patients [J].Cancer,2012,118(3):620- 627.
[21] Beressi N,Campos JM,Beressi JP,et al.Sporadic medullary microcarcinoma of the thyroid:a retrospective analysis of eighty cases [J].Thyroid,1998,8(11):1039-1044.
[22] Peix JL,Braun P,Saadat M,et al.Occult micro medullary thyroid carcinoma:therapeutic strategy and follow-up [J].World J Surg,2000,24(11):1373-1376.
[23] Hamy A,Pessaux P,Mirallié E,et al.Central neck dissection in the management of sporadic medullary thyroid microcarcinoma [J].Eur J Surg Oncol,2005,31(7):774- 777.
[24] Kim JH,Pyo JS,Cho WJ.Clinicopathological significance and prognosis of medullary thyroid microcarcinoma:a meta-analysis [J].World J Surg,2017,41(10):2551-2558.