摘要
分化型甲状腺癌已成为我国常见恶性肿瘤之一。乳头状癌构成比上升,早期病人比例增加,微小癌、单侧多发以及双侧病变发生比例增高成为分化型甲状腺癌的重要临床流行病学特征,均将影响临床外科处理方案的制定。超声影像技术的不断发展不仅利于发现更多的分化型甲状腺癌亚临床病灶、提升术前诊断准确性,还有助于介导术前临床分期,这是规范流程的起点和基础。超声影像与针吸技术相结合的诊断方法将成为今后国内切实可行的发展方向。分化型甲状腺癌另一个重要诊疗关键是病人危险分层的评估,基于危险分层评估基础上的个体化、功能性和多学科综合治疗将成为分化型甲状腺癌治疗的主流。放射性同位素内放射、促甲状腺激素(TSH)抑制以及分子靶向治疗将逐渐更为临床所接受。加强国内专业间的交流和培训、建立国人的特色指南均是近期的重要任务。
The incidence and clinical burden of thyroid cancer as well as differentiated thyroid cancer（DTC） is sharply increasing in recent years in China. The raising proportion of the papillary thyroid carcinoma, micro-carcinoma, early stage, unilateral inuhifocal and bilateral lesions is becoming the significant clinical epidemiologic character. Ultrasonography is helpful to detect more and more subclinical tumors, increase the diagnostic accuracy, also guide to identify the clinical stage（T, N stage） before the operation. Ultrasound combined with needle aspiration will be vast diagnostic majority of DTC in the near future in China. Another so important key point during the diagnosis and treatment of DTC is risk-group definition, which can assist to decide the therapeutic protocol and prognostic judgement. Personalized, functional and multidisciplinary therapy based on the risk definition will be the main trends of DTCtreatment. Radioiodine, TSH suppression and target therapy will be gradually accepted by clinician. The next prime missions should focus on the professional communication and training, establishing domestic guideline of DTC.
出处
《中国实用外科杂志》
CSCD
北大核心
2011年第5期376-379,共4页
Chinese Journal of Practical Surgery
关键词
分化型甲状腺癌
超声影像
危险分层评估
differentiated thyroid cancer
ultrasound images
risk stratification assessment
