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甲状腺癌是临床上最常见的内分泌恶性肿瘤,根据组织学形态可分为乳头状癌、滤泡状癌、髓样癌和未分化癌。临床上通常将甲状腺乳头状癌(papilary thyroid carcinoma,PTC)和甲状腺滤泡状癌(follicular thyroid carcinoma,FTC)称为分化型甲状腺癌(differentiated thyroid carcinoma,DTC)。DTC起源于甲状腺滤泡上皮细胞,在甲状腺恶性肿瘤中占据90%以上,分化良好,复发率低。30%~80%的PTC患者在确诊时即存在颈部淋巴结转移[1]。部分DTC分化不良,如实体型、柱状细胞型、高细胞型、弥漫硬化型等甲状腺癌,容易复发并发生局部及远处转移[2]。目前临床多以超声、CT、磁共振、核素显像和病理手段进行诊断,治疗上主要是以手术切除为主,辅以131I与TSH抑制治疗的三联序贯疗法。DTC的诊疗手段在不断地创新进步,本文重点阐述DTC的诊疗现状及进展。
新标准引导下的分化型甲状腺癌的临床诊疗现状
Current status of diagnosis and treatment in differentiated thyroid carcinoma under the guidance of new standards
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摘要: 分化型甲状腺癌是最常见的内分泌系统肿瘤,可以分为乳头状甲状腺癌和滤泡状甲状腺癌。目前临床诊断以超声检查为主,治疗以手术为主,辅以促甲状腺激素抑制治疗和131I治疗。近年来,分化型甲状腺癌发病率逐年升高,并居各甲状腺癌之首,同期不断有新的研究发现并提出新的诊治观点。为此,笔者拟对分化型甲状腺癌的诊疗现状及最新进展进行综述。Abstract: Differentiated thyroid carcinoma(DTC), which can be divided into papillary thyroid carcinoma and follicular thyroid carcinoma, is the most common malignant tumor of the endocrine system. Ultrasound of DTC features important clinical value. The treatment of DTC includes surgery, thyroid stimulating hormone-suppression, and 131I radiotherapy in vivo. DTC presents the highest incidence of thyroid cancer, and the value has increased annually in recent years. At the same time, new research have constantly put forward new viewpoints in diagnosis and treatment of DTC. The diagnosis and treatment of differentiated thyroid carcinoma were investigated and reviewed in this article.
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