重组人促甲状腺激素和促再分化药物在分化型甲状腺癌中的应用

孟召伟 ,  谭建

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重组人促甲状腺激素和促再分化药物在分化型甲状腺癌中的应用

  • 300052 天津, 天津医科大学总医院核医学科

    • 通讯作者: 孟召伟, james_mencius@eyou.com ; 

  • 中图分类号: R730.54

Application of recombinant human thyrotropin and redifferentiation drugs in differentiated thyroid cancer

  • Nuclear Medicine Department of Tianjin Medical University General Hospital, Tianjin 300052, China

    • Corresponding author: MENG Zhao-wei, james_mencius@eyou.com ;

  • CLC number: R730.54

  • 摘要: 131Ⅰ去除术后残留甲状腺组织和131I治疗转移灶是分化型甲状腺癌(DTC)联合治疗方案中的重要组成部分。治疗前,最关键的准备是使促甲状腺激素(TSH)升高到适合的水平。重组人促甲状腺激素(rhTSH)可以有效地使血清TSH水平升高,rhTSH与内源TSH有相同的结构和生物活性,应用rhTSH副作用轻微,并可避免因停用甲状腺激素治疗而使患者出现的甲减症状。部分DTC患者的癌灶会发生失分化,造成病情恶化、预后变差,并对131Ⅰ治疗不再敏感。以异维甲酸为代表的促进再分化药物的研究已进入Ⅱ期临床阶段,取得了一定的突破,成为失分化DTC患者131Ⅰ治疗前准备的重要手段。
    Abstract: In the management of differentiated thyroid cancer, radioiedine (131Ⅰ) ablation of thyroid remnants and 131Ⅰ treatment of metastatic lesions are very important. To prepare for ablation or treatment, optimal level of TSH has to be achieved. Recombinant human thyretropin (rhTSH) has the same structure and biological activity as endogenous TSH. It can effectively elevate serum TSH level and it has tittle side effects, rhTSH can also avoid hypothyroid symptoms which are sometimes very serious if withdrawal of thyroid hormone therapy is carried out. However, in a number of cases, dedifferentiation is observed, giving rise to poor prognostic thyroid cancers that are refractory to conventional treatment. Several novel approaches for the treatment of dedifferentiated thyroid cancers have made great breakthroughs. For instance, isotretinoin redifferentiation therapy has entered Phase Ⅱ clinical trials.
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  • 收稿日期:  2006-05-20

重组人促甲状腺激素和促再分化药物在分化型甲状腺癌中的应用

  • 收稿日期: 2006-05-20

摘要: 131Ⅰ去除术后残留甲状腺组织和131I治疗转移灶是分化型甲状腺癌(DTC)联合治疗方案中的重要组成部分。治疗前,最关键的准备是使促甲状腺激素(TSH)升高到适合的水平。重组人促甲状腺激素(rhTSH)可以有效地使血清TSH水平升高,rhTSH与内源TSH有相同的结构和生物活性,应用rhTSH副作用轻微,并可避免因停用甲状腺激素治疗而使患者出现的甲减症状。部分DTC患者的癌灶会发生失分化,造成病情恶化、预后变差,并对131Ⅰ治疗不再敏感。以异维甲酸为代表的促进再分化药物的研究已进入Ⅱ期临床阶段,取得了一定的突破,成为失分化DTC患者131Ⅰ治疗前准备的重要手段。

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