Thyroid Disease Diagnosis and Treatment Center, First Affiliated Hospital of Kunming Medical University, Yunnan, China.
Kunming Medical University, Yunnan, China.
Endocrine. 2024 Dec;86(3):1081-1089. doi: 10.1007/s12020-024-03958-2. Epub 2024 Jul 15.
To explore individualized treatment and management methods for medullary thyroid microcarcinoma (MTMC).
Clinical data of patients with medullary thyroid carcinoma with a diameter ≤1 cm admitted to the First Affiliated Hospital of Kunming Medical University from June 2013 to June 20× were collected. Combined with different treatment guidelines for medullary thyroid carcinoma, factors affecting lymph node metastasis and postoperative disease status were analyzed.
Twenty-nine patients with MTMC were included in the analysis, including 24 patients who underwent total thyroidectomy, 5 who underwent thyroid gland lobectomy, and 13 who experienced postoperative lymph node metastasis. Multifocal tumor and calcitonin (Ctn) were the influencing factors, while multifocal tumor, Ctn, lymph node metastasis, and AJCC stage affected the dynamic risk stratification of postoperative disease.
Calcitonin detection is an important method for detecting MTMC. A tumor diameter ≤1 cm does not indicate that the tumor is in the early stage. The presence of multifocal tumors and Ctn should be used as important indicators for preoperative evaluation. Dynamic stratified risk assessment is critical in postoperative follow-up.
探讨甲状腺髓样微癌（MTMC）的个体化治疗和管理方法。
收集昆明医科大学第一附属医院 2013 年 6 月至 20×年 6 月收治的直径≤1cm 的甲状腺髓样癌患者的临床资料，结合不同的甲状腺髓样癌治疗指南，分析影响淋巴结转移及术后疾病状态的因素。
纳入 MTMC 患者 29 例，其中行甲状腺全切除术 24 例，甲状腺叶切除术 5 例，术后发生淋巴结转移 13 例。多灶性肿瘤和降钙素（Ctn）是影响淋巴结转移的因素，而多灶性肿瘤、Ctn、淋巴结转移和 AJCC 分期影响术后疾病的动态危险分层。
降钙素检测是 MTMC 检测的重要方法。肿瘤直径≤1cm 并不表明肿瘤处于早期阶段。多灶性肿瘤和 Ctn 应作为术前评估的重要指标。术后随访中进行动态分层风险评估至关重要。
