Trimboli Pierpaolo, Crescenzi Anna, Saggiorato Enrico, Treglia Giorgio, Giovanella Luca
Department of Nuclear Medicine and Thyroid Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland -
Section of Pathology, Campus Bio-Medico University Hospital, Rome, Italy.
Minerva Endocrinol. 2017 Sep;42(3):238-247. doi: 10.23736/S0391-1977.16.02579-7. Epub 2016 Nov 3.
The correct identification of medullary thyroid carcinoma (MTC) has been a challenge since its first description. In the last few years, some advances in this context have been achieved. Here we aimed to review and discuss published data on the more recent acquisition in the diagnosis of MTC.
A literature search of the medical databases was conducted by searching papers reporting tool for diagnosis of MTC published in the last years. The search was updated until July 2016.
The literature search revealed several relevant articles which focused on different topics of the diagnosis of MTC. The results are reported by four paragraphs, such as 1) fine-needle aspiration; 2) molecular analysis; 3) serum markers; 4) imaging.
The measurement of calcitonin in FNA washout fluids is essential due to poor accuracy of conventional cytology to detect MTC. Genetic analysis can help to identify those advanced MTC with poorer prognosis who do not respond to chemotherapy. Procalcitonin may in the next future replace calcitonin as serum diagnostic marker of MTC. Recent evidence based data seem to suggest the emerging role of functional imaging in recurrent MTC in patients with calcitonin serum levels >150 pg/mL.
自首次描述以来,甲状腺髓样癌(MTC)的正确诊断一直是一项挑战。在过去几年中,这方面已取得了一些进展。在此,我们旨在回顾和讨论已发表的有关MTC诊断方面最新成果的数据。
通过检索近年来报道的MTC诊断工具的论文,对医学数据库进行了文献检索。检索更新至2016年7月。
文献检索发现了几篇相关文章,这些文章聚焦于MTC诊断的不同主题。结果分四段报告,如1)细针穿刺抽吸;2)分子分析;3)血清标志物;4)影像学。
由于传统细胞学检测MTC的准确性较差,因此在细针穿刺冲洗液中测量降钙素至关重要。基因分析有助于识别那些对化疗无反应、预后较差的晚期MTC。在未来,降钙素原可能会取代降钙素作为MTC的血清诊断标志物。最近基于证据的数据似乎表明,功能成像在血清降钙素水平>150 pg/mL的复发性MTC患者中发挥着越来越重要的作用。