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近年来,全球甲状腺癌的发病率逐年升高[1]。甲状腺乳头状癌(papillary thyroid carcinoma, PTC)起源于甲状腺滤泡上皮细胞,占DTC的90%以上,是甲状腺癌最常见的组织病理学类型[2]。PTC患者发生淋巴结转移较早,但其诊断无特异性肿瘤标志物,术前辅助检查可以提高淋巴结转移的检出率,但在确诊PTC且无淋巴结转移证据的患者中,隐匿性颈部淋巴结转移的发生率高达51%[3],因此早期精准诊断十分必要。PTC患者术后易复发转移,中央区或侧颈部淋巴结复发称为颈局部复发,占所有复发的79%,其中以淋巴结复发最常见,高达74%[4],且淋巴结转移缺乏有效的治疗方法。本文从PTC淋巴结转移的机制、诊断及治疗等方面进行阐述。
甲状腺乳头状癌淋巴结转移诊疗现状研究
Diagnosis and treatment of lymph node metastasis of papillary thyroid carcinoma
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摘要: 甲状腺乳头状癌(PTC)是甲状腺癌最常见的组织病理学类型,其淋巴结转移影响患者的预后。目前PTC的淋巴结转移机制尚不明确,其诊断方法包括超声、细针穿刺活检、CT、MRI、SPECT/CT、PET/CT等,但特异度及灵敏度均不高,联合使用可以提高检出率。PTC淋巴结转移首选的治疗方式是手术。目前PTC淋巴结转移早期综合诊断及有效治疗是改善和提高PTC患者生活质量的难点。笔者就PTC淋巴结转移的诊疗现状及研究进展进行综述。Abstract: Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid carcinoma. And lymph node metastasis affects the prognosis of patients. At present, the mechanism of lymph node metastasis of PTC is not clear, and its diagnostic methods include ultrasound, fine needle puncture biopsy, CT, MRI, SPECT/CT, PET/CT etc., but the specificity and sensitivity are not high, combined use can improve the detection rate. The preferred treatment for lymph node metastasis of PTC is surgery. At present, early comprehensive diagnosis and effective treatment of PTC lymph node metastasis are problems to improve and enhance the quality of life of PTC patients.This article reviews the diagnosis and treatment status, and research progress of PTC lymph node metastasis.
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Key words:
- Thyroid cancer, papillary /
- Risk factors /
- Radionuclide imaging /
- Lymph node metastasis
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