甲状腺髓样癌的手术治疗.PDF

中国普外基础与临床杂志 2018 年7 月第25 卷第x 期 • 1 •   ·综　述 · 甲状腺髓样癌的手术治疗 粟喆，胡亚 中国医学科学院北京协和医院基本外科（北京  100730 ） 【摘要】   目的     阐述甲状腺髓样癌手术治疗的研究进展。方法    检索近年来甲状腺髓样癌治疗的相关文献 并进行综述。结果    对甲状腺髓样癌患者进行甲状腺全切除术的同时清扫颈部淋巴结是有效的手术方式，但具 体的清扫范围仍存在争议。存在 RET 基因突变的患者应进行预防性甲状腺切除术。甲状腺髓样癌远处转移治疗 以改善症状为主。结论    手术是甲状腺髓样癌的主要治疗手段。通过术前对淋巴结受累范围进行充分评估，结 合基因检测明确甲状腺髓样癌的类型并选择恰当的手术时机及方式有助于改善甲状腺髓样癌患者的预后。 【关键词】   甲状腺髓样癌；手术治疗；淋巴结清扫术；综述 The Surgery treatment of medullary thyroid carcinoma SU Zhe, HU Ya Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, P. R. China Corresponding author: HU Ya, Email: huyafrank@ 【Abstract 】 Objective    To summarize the clinical and research status in the surgical management of medullary thyroid carcinoma. Methods    The related literatures on treatment of medullary thyroid carcinoma were collected and reviewed. Results    A total thyroidectomy and dissection of the lymph nodes in the central compartment were effective treatments for patients with medullary thyroid carcinoma. The extent of lateral compartment lymph-node dissection did not reach an agreement. Prophylactic thyroidectomy was suggested for patients with a RET (rearranged during transfection) germline mutation. Palliative therapy was the main treatment of metastatic medullary thyroid carcinoma. Conclusions    Surgery is the mainstay of treatment for medullary thyroid carcinoma. The combination of preoperative assessment, genetic testing, and appropriate surgical strategy may improve the prognosis of patients with medullary thyroid carcinoma. 【Keywords 】 medullary thyroid carcinoma; surgery; lymph node dissection; review 甲状腺髓样癌（medullary thyroid