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《论测量髓样甲状腺癌(MTC)患者术前和术后癌胚抗原(CEA)值的意义》述评。

A Review of the Significance in Measuring Preoperative and Postoperative Carcinoembryonic Antigen (CEA) Values in Patients with Medullary Thyroid Carcinoma (MTC).

机构信息

1st Department of Surgery, "Papageorgiou" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece.

Department of Neurosurgery, 424 General Military Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece.

出版信息

Medicina (Kaunas). 2021 Jun 11;57(6):609. doi: 10.3390/medicina57060609.

Abstract

: Medullary thyroid carcinoma (MTC) accounts for 1-2% of all thyroid malignancies, and it originates from parafollicular "C" cells. Carcinoembryonic antigen (CEA) is a tumor marker, mainly for gastrointestinal malignancies. There are references in literature where elevated CEA levels may be the first finding in MTC. The aim of this study is to determine the importance of measuring preoperative and postoperative CEA values in patients with MTC and to define the clinical significance of the correlation between CEA and the origin of C cells. : The existing and relevant literature was reviewed by searching for articles and specific keywords in the scientific databases of PubMedCentraland Google Scholar (till December 2020). : CEA has found its place, especially at the preoperative level, in the diagnostic approach of MTC. Preoperative CEA values >30 ng/mL indicate extra-thyroid disease, while CEA values >100 ng/mL are associated with lymph node involvement and distant metastases. The increase in CEA values preoperatively is associated with larger size of primary tumor, presence of lymph nodes, distant metastases and a poorer prognosis. The clinical significance of CEA values for the surgeon is the optimal planning of surgical treatment. In the recent literature, C cells seem to originate from the endoderm of the primitive anterior gut at the ultimobranchial bodies' level. : Although CEA is not a specific biomarker of the disease in MTC, itsmeasurement is useful in assessing the progression of the disease. The embryonic origin of C cells could explain the increased CEA values in MTC.

摘要

甲状腺髓样癌(MTC)占所有甲状腺恶性肿瘤的 1-2%,起源于滤泡旁“C”细胞。癌胚抗原(CEA)是一种肿瘤标志物,主要用于胃肠道恶性肿瘤。文献中有提到,CEA 水平升高可能是 MTC 的首发表现。本研究旨在确定测量 MTC 患者术前和术后 CEA 值的重要性,并确定 CEA 与 C 细胞起源之间的相关性的临床意义。

通过在 PubMedCentral 和 Google Scholar 的科学数据库中搜索文章和特定关键词,回顾了现有的相关文献(截至 2020 年 12 月)。

CEA 在 MTC 的诊断方法中找到了自己的位置,特别是在术前水平。术前 CEA 值>30ng/mL 提示甲状腺外疾病,而 CEA 值>100ng/mL 与淋巴结受累和远处转移有关。术前 CEA 值的升高与原发肿瘤的大小较大、存在淋巴结、远处转移和预后较差有关。CEA 值对外科医生的临床意义是手术治疗的最佳规划。在最近的文献中,C 细胞似乎起源于原始前肠的内胚层,位于终末鳃体水平。

虽然 CEA 不是 MTC 疾病的特异性生物标志物,但测量 CEA 值有助于评估疾病的进展。C 细胞的胚胎起源可以解释 MTC 中 CEA 值的增加。

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