Feldkamp J
Klinik und Poliklinik für Endokrinologie, Heinrich-Heine-Universität Düsseldorf.
Praxis (Bern 1994). 1998 Mar 11;87(11):389-93.
The 10 year survival is excellent for stage I disease thyroid carcinoma. Survival decreases as a function of cancer invasion beyond the gland. Papillary and follicular cancers have longterm survival, but anaplastic cancers are lethal and survival is short. In differentiated carcinomas thyroidectomy and neck dissection are followed by radioiodine therapy to eliminate residual tissue and metastases. In case of papillary microcarcinomas a limited resection is justified. There is no need for radioiodine treatment. Thyroid hormones are given postoperatively in a high dose to suppress TSH. An increase of the tumor marker thyreoglobulin indicates the development of relapse or metastases. In medullary carcinoma basal or serum calcitonin levels after stimulation with pentagastrin-elicited are pathognomonic for a relapse. 25% of the medullary thyroid carcinomas are observed in families. Genetic screening is mandatory in patients with medullary carcinoma. Serum calcium values should be controlled to exclude safely hypoparathyroidism with certitude.
甲状腺癌I期疾病的10年生存率极佳。生存率会随着癌症侵犯超出腺体而降低。乳头状癌和滤泡状癌有长期生存率，但未分化癌是致命的，生存率很短。在分化型癌中，甲状腺切除术和颈部清扫术后会进行放射性碘治疗以消除残留组织和转移灶。对于乳头状微小癌，进行有限切除是合理的。无需进行放射性碘治疗。术后给予高剂量甲状腺激素以抑制促甲状腺激素（TSH）。肿瘤标志物甲状腺球蛋白升高表明复发或转移的发生。在髓样癌中，五肽胃泌素刺激后基础或血清降钙素水平对复发具有诊断意义。25%的甲状腺髓样癌在家族中被观察到。对髓样癌患者进行基因筛查是必需的。应控制血清钙值以安全地排除甲状旁腺功能减退症。
