Ward Laura S, Marrone Marilia, Camargo Rosalinda Y, Watanabe Tomoko, Tincani Alfio J, Matos Patricia S, Assumpção Ligia V M, Tomimori Eduardo, Kulcsar Marco Aurélio, Nunes Maria Tereza, Nogueira Célia R, Kimura Edna T
Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas/UNICAMP, 13081-970 Campinas, SP.
Arq Bras Endocrinol Metabol. 2006 Jun;50(3):550-7. doi: 10.1590/s0004-27302006000300019.
The trend of increasing thyroid cancer has been recognized in Brazil as well as all over the world for several decades. The large use of simple and effective diagnostic tools has significantly contributed to this trend. It is estimated that small carcinomas found at surgery for benign thyroid disorders and by ultrasonography will be identified at greater frequency in the further years. Part of these tumors occurs in low-risk patients that may benefit of less aggressive management strategies. However, the characterization of low-risk patient is still confusing and we lack adequate markers to tell apart patients that may present a troublesome progression of the disease. Furthermore, the use of new follow-up methods has recently changed some guidelines. A multidisciplinary team, including basic scientists, endocrinologists, nuclear medicine physicians, thyroid surgeons and endocrine pathologists reviewed the pertinent literature and, based on their experience, propose some management guidelines for Brazilian patients with low-risk thyroid carcinomas.
几十年来,甲状腺癌发病率上升的趋势在巴西以及全球都已得到公认。简单有效的诊断工具的广泛使用极大地推动了这一趋势。据估计,因良性甲状腺疾病接受手术以及通过超声检查发现的小癌灶在未来几年将被更频繁地识别出来。这些肿瘤中有一部分发生在低风险患者身上,他们可能受益于不太激进的管理策略。然而,低风险患者的特征仍不明确,我们缺乏足够的标志物来区分那些可能出现疾病麻烦进展的患者。此外,新的随访方法的应用最近改变了一些指南。一个由基础科学家、内分泌学家、核医学医师、甲状腺外科医生和内分泌病理学家组成的多学科团队回顾了相关文献,并根据他们的经验,为巴西低风险甲状腺癌患者提出了一些管理指南。