Wang X, Li C, Huang L, Shui C Y, Liu W, Cai Y C, Sun R H, Zhou Y Q, Jiang J, Wang W, Zeng D F
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Institute of Cancer Research, Sichuan Cancer Prevention and Control Center, Cancer Hospital affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China ; Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital, Southwest Medical University, Luzhou 646200, China.
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Institute of Cancer Research, Sichuan Cancer Prevention and Control Center, Cancer Hospital affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr 7;54(4):306-310. doi: 10.3760/cma.j.issn.1673-0860.2019.04.015.
To review and summarize recent update on preoperative diagnostic criteria, treatment and postoperative follow-up for medullary thyroid carcinoma. The relevant literatures and guidelines about medullary thyroid carcinoma were analyzed and summarized. In the early stages of the disease radical surgery still dominated. Ultrasound results suggested that prophylactic lateral neck dissection was required for patients with high risk factors or high levels of carcinoembryonic antigen and calcitonin need prophylactic. Early hereditary medullary carcinoma could receive prophylactic thyroidectomy based on RET gene test results. Advanced progressive medullary thyroid carcinoma could be treated with palliative surgery,molecular targeted drugs and chemotherapy. The prognosis of medullary thyroid carcinoma is poor and lymph node metastasis is easy to occur early. The extent of initial operation should be enough. Locally advanced or distant metastatic medullary thyroid carcinoma can be treated with palliative surgery,molecular targeted drugs and chemotherapy.
回顾和总结甲状腺髓样癌术前诊断标准、治疗及术后随访的最新进展。对甲状腺髓样癌的相关文献和指南进行分析和总结。在疾病早期，根治性手术仍占主导地位。超声结果提示，高危因素患者或癌胚抗原及降钙素水平高的患者需要预防性侧颈清扫。早期遗传性髓样癌可根据RET基因检测结果行预防性甲状腺切除术。晚期进展性甲状腺髓样癌可采用姑息性手术、分子靶向药物和化疗。甲状腺髓样癌预后较差，早期易发生淋巴结转移。初次手术范围应足够。局部晚期或远处转移的甲状腺髓样癌可采用姑息性手术、分子靶向药物和化疗。
