Angeli Giorgio, Brazzarola Paolo, Bottura Daniela, Bonomo Serena, Castellini Cristiana, Moser Alberto, Vicenzi Luca, Mazzola Francesco, Rizzo Salvatore, Betresini Barbara, Ballarin Andrea, Rosa Gennaro
Dipartimento di Scienze Chirurgiche e Gastroenterologiche Cattedra di Semeiotica e Metodologia Chirurgica Università degli Studi di Verona.
Chir Ital. 2002 Jan-Feb;54(1):25-9.
The authors report 20 cases of medullary thyroid carcinoma over the period from 1980 to 2000. Two patients turned out to be inoperable and 18 patients underwent total thyroidectomy, associated with dissection of the central lymphatic compartment in 5 patients and with dissection of the central and lateral lymphatic compartments in 10 patients with clinical or instrumental evidence of cervical lymphadenomegaly. Serum calcitonin levels proved to be a reliable marker for the diagnosis of persistence or recurrence of the disease. The follow-up, lasting from 1 to 208 months, demonstrated that in 7 cases in which serum levels of calcitonin underwent normalization there was no recurrence of disease. Among 11 cases with persistence of high calcitonin levels, 6 died and only 2 presented no evidence of metastases. On the basis of our analysis of the cases reported, total thyroidectomy associated with dissection of the central lymphatic compartment is an adequate treatment for patients in stages I and II. The authors regard routine dissection of the lateral lymphatic compartment as unadvisable.
作者报告了1980年至2000年期间的20例甲状腺髓样癌病例。2例患者无法手术，18例患者接受了全甲状腺切除术，其中5例患者同时进行了中央淋巴结清扫，10例有颈部淋巴结肿大临床或影像学证据的患者同时进行了中央和侧方淋巴结清扫。血清降钙素水平被证明是诊断疾病持续或复发的可靠标志物。随访时间为1至208个月，结果显示，7例血清降钙素水平恢复正常的患者无疾病复发。在11例降钙素水平持续升高的患者中，6例死亡，只有2例无转移证据。根据我们对所报告病例的分析，全甲状腺切除术联合中央淋巴结清扫是I期和II期患者的充分治疗方法。作者认为常规进行侧方淋巴结清扫不可取。
