Ito Yasuhiro, Miyauchi Akira, Kihara Minoru, Kudo Takumi, Miya Akihiro
Department of Surgery, Kuma Hospital, Kobe, Japan.
Endocr J. 2016 Jul 30;63(7):663-7. doi: 10.1507/endocrj.EJ16-0140. Epub 2016 Apr 19.
Therapy using tyrosine-kinase inhibitors (TKIs) is now available for recurring or advanced medullary thyroid carcinoma (MTC). Here we investigated the calcitonin doubling time (Ct-DT) of MTC patients with distant recurrence postoperatively and for those with distant metastasis at the initial surgery. Of the 13 patients, six died due to the MTC at 5-93 months after the detection of distant metastasis. Their Ct-DTs were ≤ 1.58 years. The remaining seven patients have been alive for 73-123 months after the detection of metastasis, and their Ct-DTs were low at -4, -2.25 years and 9.17-33.92 years. Similar results were obtained by analyzing the value of 1/Ct-DT to avoid discontinuity in the DT values among the patients with increasing serum Ct values over time and those with decreasing Ct values over time. These findings suggest that it is appropriate to use TKIs only for patients with a short Ct-DT and a large 1/Ct-DT with a cutoff at around 1.5 years and 0.67/year, respectively, even if they have distant metastases.
酪氨酸激酶抑制剂（TKIs）疗法现已可用于复发性或晚期甲状腺髓样癌（MTC）。在此，我们研究了术后远处复发的MTC患者以及初次手术时有远处转移的MTC患者的降钙素倍增时间（Ct-DT）。13例患者中，6例在检测到远处转移后5至93个月因MTC死亡。他们的Ct-DT≤1.58年。其余7例患者在检测到转移后存活了73至123个月，其Ct-DT较低，分别为-4年、-2.25年以及9.17至33.92年。通过分析1/Ct-DT的值也获得了类似结果，以避免随着时间推移血清Ct值升高的患者和Ct值降低的患者之间的DT值出现不连续情况。这些发现表明，即使患者有远处转移，仅对Ct-DT短且1/Ct-DT大的患者使用TKIs是合适的，其截断值分别约为1.5年和0.67/年。
