家族性非髓样甲状腺癌的前瞻性筛查。
Prospective screening in familial nonmedullary thyroid cancer.
机构信息
Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.
出版信息
Surgery. 2013 Dec;154(6):1194-8. doi: 10.1016/j.surg.2013.06.019. Epub 2013 Aug 23.
BACKGROUND
Approximately 8% of nonmedullary thyroid cancers are familial. The optimal age for screening in familial nonmedullary thyroid cancer (FNMTC) is unknown.
METHODS
Kindreds with FNMTC (2 or more first-degree relatives affected) were screened prospectively with thyroid ultrasonography.
RESULTS
Fifteen kindreds showed an overall prevalence of thyroid nodule(s) ≥5 mm of 44% at screening; 19% in the second generation, and 90% in the generation anterior to the index case. The youngest age of detection was 10 years for thyroid nodules and 18 years for thyroid cancer. Microcalcification of thyroid nodules at screening was associated with a greater risk of cancer (P < .05). Family members diagnosed with thyroid cancer by ultrasonographic screening were diagnosed at a younger age and had a lower rate of extra thyroidal invasion (P < .05).
CONCLUSION
In FNMTC, first-degree relatives 10 years or older, including the generation anterior to the index case, should have thyroid screening by ultrasonography, which may result in earlier diagnosis.
背景
约 8%的非髓样甲状腺癌为家族性。家族性非髓样甲状腺癌（FNMTC）的最佳筛查年龄尚不清楚。
方法
对有 FNMTC（2 个或更多一级亲属受影响）的家族进行前瞻性甲状腺超声筛查。
结果
15 个家族在筛查时总体甲状腺结节（≥5 毫米）的检出率为 44%；第二代为 19%，前一代为 90%。甲状腺结节和甲状腺癌的最早检出年龄分别为 10 岁和 18 岁。筛查时甲状腺结节的微钙化与更高的癌症风险相关（P<0.05）。通过超声筛查诊断为甲状腺癌的家族成员的诊断年龄较小，且甲状腺外侵犯的发生率较低（P<0.05）。
结论
在 FNMTC 中，10 岁或以上的一级亲属，包括前一代，应通过超声检查进行甲状腺筛查，这可能导致更早的诊断。
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