Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Rochester School of Medicine & Dentistry, Rochester, NY, USA.
Department of Medicine, Division of Endocrinology, Metabolism and Lipid Research, Washington University in St. Louis, St. Louis, MO, USA.
Endocrine. 2024 Feb;83(2):251-258. doi: 10.1007/s12020-023-03548-8. Epub 2023 Oct 12.
This review focuses on post-operative thyroid hormone replacement and thyrotropin suppression therapy in patients with differentiated thyroid cancer.
A clinical review.
Differentiated thyroid cancers (DTC), including papillary and follicular thyroid cancers, have an excellent prognosis and their management leverages a unique set of clinical tools arising from homology to the normal thyroid follicular cell. Surgery is the cornerstone of initial management, and post-operative care often requires thyroid hormone replacement therapy, which may be approached with the intent of physiologic normalization or used pharmacologically to suppress TSH as part of a DTC treatment.
Management of DTC and approaches to TSH suppression are tailored to an individual's risk of DTC recurrence and are adjusted to a patient's clinical status and comorbidities over time with the goal of mitigating risk and maximizing benefit.
本篇综述聚焦于分化型甲状腺癌患者术后甲状腺激素替代和促甲状腺素抑制治疗。
临床综述。
分化型甲状腺癌（DTC）包括乳头状和滤泡状甲状腺癌，其预后极好，其管理得益于一套独特的临床工具，这些工具源自与正常甲状腺滤泡细胞的同源性。手术是初始管理的基石，术后护理通常需要甲状腺激素替代治疗，其可以通过生理正常化的目的来进行，也可以通过药理学抑制 TSH 作为 DTC 治疗的一部分。
DTC 的管理和 TSH 抑制的方法根据 DTC 复发的风险进行调整，并随着时间的推移根据患者的临床状况和合并症进行调整，目的是降低风险并使获益最大化。
