Zechmann C M, Haufe S
Abteilung Nuklearmedizin, Universität Heidelberg, Im Neuenheimer Feld 400, Heidelberg, Germany.
Radiologe. 2012 Aug;52(8):761-72; quiz 773-4. doi: 10.1007/s00117-012-2377-1.
Malignant thyroid diseases have increased in recent years. The distinction between differentiated and non-differentiated thyroid carcinoma is essential for therapy and follow-up. The frequently diagnosed papillary and follicular thyroid carcinomas are differentiated and have a good prognosis. Clinical symptoms are relatively unspecific, however imaging and laboratory testing can often provide evidence for diagnosis of thyroid carcinoma. Therapy typically involves surgery, ablative radioiodine therapy and subsequent suppressive hormone substitution. The pillars of follow-up are diagnostic scintigraphy, sonography and laboratory tests. Redifferentiation or a change of the tracer can make dedifferentiated tumors again susceptible to nuclide therapy. New treatment options have become available with the introduction of tyrosine kinase inhibitors.
近年来,恶性甲状腺疾病有所增加。区分分化型和未分化型甲状腺癌对于治疗和随访至关重要。常见的乳头状和滤泡状甲状腺癌属于分化型,预后良好。临床症状相对不具特异性,然而影像学和实验室检查通常可为甲状腺癌的诊断提供依据。治疗通常包括手术、放射性碘消融治疗以及随后的抑制性激素替代治疗。随访的关键是诊断性闪烁扫描、超声检查和实验室检查。再分化或示踪剂的改变可使去分化肿瘤再次对核素治疗敏感。随着酪氨酸激酶抑制剂的引入,出现了新的治疗选择。