Gavrailov M, Petkov R, Mladenov B, Todorov G, Kŭtev N
Khirurgiia (Sofiia). 1995;48(2):17-9.
Over the period 1977 through 1988, in the Research Institute of Surgery--Medical Academy a total of 372 patients undergo primary operative management for thyroid gland carcinoma. Medullary carcinoma is discovered in 18 patients of the series (4.8 per cent). The preoperative diagnosis is supplemented by thyroscintigraphy with 131iodine or technetium Tc 201. After 1981, calcitonin and carcinoembryonic antigen (CEA), specific medullary thyroid carcinoma (MTC) markers, measurements are routinely done, with substantially elevated levels in the patients under study being found, in those with metastases inclusive. Presumably, the preoperative diagnosis medullary thyroid carcinoma is very difficult, and only a combined approach, including thyroidectomy with ensuing iodine radiotherapy, may account for a good survivorship. Postoperatively, all patients with MTC diagnosis are regularly tested for serum calcitonin and CEA levels. The carefully taken family history and questioning of the patients allows to differentiate familial from cases from sporadic neoplasms.
在1977年至1988年期间，在外科医学研究院，共有372例患者接受了甲状腺癌的初次手术治疗。该系列中有18例患者被发现患有髓样癌（4.8%）。术前诊断通过131碘或锝Tc 201甲状腺闪烁显像进行补充。1981年以后，降钙素和癌胚抗原（CEA），即甲状腺髓样癌（MTC）的特异性标志物，被常规检测，在包括有转移的研究患者中发现其水平大幅升高。据推测，术前诊断甲状腺髓样癌非常困难，只有包括甲状腺切除及后续碘放疗的联合方法，才可能带来良好的生存率。术后，所有诊断为MTC的患者都定期检测血清降钙素和CEA水平。仔细采集家族史并询问患者，有助于区分家族性肿瘤和散发性肿瘤病例。
