分化型甲状腺癌研究进展
Research Progress of Differentiated Thyroid Carcinoma
DOI: 10.12677/MD.2017.73010, PDF, HTML, XML, 下载: 1,686  浏览: 4,121  科研立项经费支持
作者: 莫景菊, 李俊红*, 韦智晓, 张筱楠:广西医科大学第一附属医院核医学科,广西 南宁
关键词: 分化型甲状腺癌研究进展Differentiated Thyroid Carcinoma Research Progress
摘要: 在内分泌恶性肿瘤中,甲状腺癌发病率最高、发病率增长最迅速。每一年的新发例数约占全身所有恶性肿瘤的1.1%,DTC占90%以上,DTC中主要包括85%的乳头状癌和10%的滤泡状癌。DTC患者10年生存率为90%,约10%出现转移,远处转移肺为主、骨次之,骨转移患者10年生存率仅13%~21%,这已成为患者死亡的主要原因。早期诊治尤为重要,现对DTC诊疗新进展简要综述,包括血清甲状腺球蛋白、促甲状腺激素、131I-WBS、18FPET/CT。
Abstract: In endocrine malignancies, the incidence of thyroid cancer is the highest, and the incidence is the fastest growing. Every year the new number of cases accounted for about 1.1% of all malignant tumors, differentiated thyroid carcinoma accounted for more than 90%, consists of 85% papillary carcinomas and 10% papillary carcinoma. DTC patients with 10 year survival rate was 90%, about 10% had metastases. Metastasis of lung was mainly located in the distance, and bone took the second place. The 10 year survival rate of bone metastasis was only 13%~21%, which has become the main reason for the death of patients. Early diagnosis is particularly important, the new progress of DTC diagnosis and treatment are briefly reviewed, including serum thyroglobulin, thyroid stimulating hormone, 131I-Whole Body Scan, 18Fluorodeoxyglucose-Positron Emission Computerized Tomography/ Computed Tomography.
文章引用:莫景菊, 李俊红, 韦智晓, 张筱楠. 分化型甲状腺癌研究进展[J]. 医学诊断, 2017, 7(3): 60-64. https://doi.org/10.12677/MD.2017.73010

参考文献

[1] 中华医学会核医学分会. 131I治疗分化型甲状腺癌指南(2014版) [J] 中华核医学与分子影像杂志, 2014, 34(4): 264-278.
[2] Jung, K.W., Won, Y.J., Kong, H.J., et al. (2013) Cancer Statistics in Korea: Incidence, Mortality, Survival and Preva-lence in 2010. Cancer Research & Treatment, 45, 1-14.
https://doi.org/10.4143/crt.2013.45.1.1
[3] Peng, J.H. (2013) Recent Cancer Statistics in China.
[4] Zanotti-Fregonara, P., Rubello, D. and Hindie, E. (2008) Bone Metastases of Differentiated Thyroid Cancer: The Importance of Early Diagnosis and 131I Therapy on Prognosis. Journal of Nuclear Medicine, 49, 1902-1903.
https://doi.org/10.2967/jnumed.108.054163
[5] Durante, C., Haddy, N., et a1. (2006) Long-Term Outcome of 444 Patients with Distant Metastases from Papillary and Follicular Thyroid Carcinoma: Benefits and Limits of Radioiodine Therapy. The Journal of Clinical Endocrinology & Metabolism, 91, 2892-2899.
https://doi.org/10.1210/jc.2005-2838
[6] Roodman, G.D. (2005) High Bone Turnover Markers Predict Poor Outcome in Patients with Bone Metastasis. Clinical Oncology, 23, 4821-4822.
https://doi.org/10.1200/JCO.2005.02.911
[7] 许艳红, 宋红俊, 邱忠领, 陈立波, 罗全勇. 以骨转移为首发症状的分化型甲状腺癌的临床特征与生存分析[J]. 肿瘤, 2011(6): 538-541.
[8] Kushnir, M.M., Rockwood, A.L., Roberts, W.L., et al. (2013) Measurement of Thyroglobulin by Liquid Chromatography-Tandem Mass Spectrometry in Serum and Plasma in the Presence of Antithyroglobulin Autoantibodies. Clinical chemistry, 59, 982-990.
https://doi.org/10.1373/clinchem.2012.195594
[9] Spencer, C.A., Bergoglio, L.M., Kazarosyan, M., et al. (2005) Clinical Impact of Thyroglobulin (Tg) and Tg Autoantibody Method Differences on the Management of Patients with Differentiated Thyroid Carcinomas. The Journal of Clinical Endocrinology & Metabolism, 90, 5566-5575.
https://doi.org/10.1210/jc.2005-0671
[10] Eustatia-Rutten, C.F.A., Smit, J.W.A., Romijn, J., et al. (2004) Diagnostic Value of Serum Thyroglobulin Measurements in the Follow-Up of Differentiated Thyroid Carcinoma, a Structured Meta-Analysis. Clinical Endocrinology, 61, 61-74.
https://doi.org/10.1111/j.1365-2265.2004.02060.x
[11] Spencer, C., Fatemi, S., Singer, P., et al. (2010) Serum Basal Thyroglobulin Measured by a Second-Generation Assay Correlates with the Recombinant Human Thyrotro-pin-Stimulated Thyroglobulin Response in Patients Treated for Differentiated Thyroid Cancer. Thyroid, 20, 587-595.
https://doi.org/10.1089/thy.2009.0338
[12] Bachelot, A., Cailleux, A.F., Klain, M., et al. (2002) Relationship between Tumor Burden and Serum Thyroglobulin Level in Patients with Papillary and Follicular Thyroid Carcinoma. Thyroid, 12, 707-711.
https://doi.org/10.1089/105072502760258686
[13] Haugen, B.R., Alexander, E.K., Bible, K.C., et al. (2015) American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 26, 1-133.
https://doi.org/10.1089/thy.2015.0020
[14] McGriff, N.J., Csako, G., Gourgiotis, L., et al. (2002) Effects of Thyroid Hormone Suppression Therapy on Adverse Clinical Outcomes in Thyroid Cancer. Annals of Medicine, 34, 554-564.
https://doi.org/10.1080/078538902321117760
[15] Diessl, S., Holzberger, B., Mäder, U., et al. (2012) Impact of Moderate vs. Stringent TSH Suppression on Survival in Advanced Differentiated Thyroid Carcinoma. Clinical Endocrinology, 76, 586-592.
https://doi.org/10.1111/j.1365-2265.2011.04272.x
[16] Cooper, D.S., Specker, B., Ho, M., et al. (1998) Thyrotropin Suppression and Disease Progression in Patients with Differentiated Thyroid Cancer: Results from the National Thyroid Cancer Treatment Coop-erative Registry. Thyroid, 8, 737-744.
https://doi.org/10.1089/thy.1998.8.737
[17] Pujol, P., Daures, J.P., Nsakala, N., et al. (1996) Degree of Thyrotropin Suppression as a Prognostic Determinant in Differentiated Thyroid Cancer. The Journal of Clinical Endocrinology & Metabolism, 81, 4318-4323.
[18] Jonklaas, J., Sarlis, N.J., Litofsky, D., et al. (2006) Outcomes of Patients with Differentiated Thyroid Carcinoma Following Initial Therapy. Thyroid, 16, 1229-1242.
https://doi.org/10.1089/thy.2006.16.1229
[19] Jeong, S.Y., Lee, S.W., Kim, H.W., et al. (2014) Clinical Applications of SPECT/CT after First I-131 Ablation in Patients with Differentiated Thyroid Cancer. Clinical Endocrinology, 81, 445-451.
https://doi.org/10.1111/cen.12460
[20] Grewal, R.K., Tuttle, R.M., Fox, J., et al. (2010) The Effect of Post-Therapy 131I SPECT/CT on Risk Classification and Management of Patients with Differentiated Thyroid Cancer. Journal of Nuclear Medicine, 51, 1361-1367.
https://doi.org/10.2967/jnumed.110.075960
[21] Kohlfuerst, S., Igerc, I., Lobnig, M., et al. (2009) Posttherapeutic 131I SPECT-CT Offers High Diagnostic Accuracy When the Findings on Conventional Planar Imaging Are Inconclusive and Allows a Tailored Patient Treatment Regimen. European Journal of Nuclear Medicine and Molecular Imaging, 36, 886.
https://doi.org/10.1007/s00259-008-1044-2
[22] Ciappuccini, R., Heutte, N., Trzepla, G., et al. (2011) Postablation 131I Scin-tigraphy with Neck and Thorax SPECT-CT and Stimulated Serum Thyroglobulin Level Predict the Outcome of Patients with Diffe-rentiated Thyroid Cancer. European Journal of Endocrinology, 164, 961-969.
https://doi.org/10.1530/EJE-11-0156
[23] Leboulleux, S., Schroeder, P.R., Schlumberger, M., et al. (2007) The Role of PET in Follow-Up of Patients Treated for Differentiated Epithelial Thyroid Cancers. Nature Clinical Practice Endocrinology & Metabolism, 3, 112-121.
https://doi.org/10.1038/ncpendmet0402
[24] Rosario, P.W., Mourao, G.F., dos Santos, J.B.N., et al. (2014) Is Empirical Ra-dioactive Iodine Therapy Still a Valid Approach to Patients with Thyroid Cancer and Elevated Thyroglobulin? Thyroid, 24, 533-536.
https://doi.org/10.1089/thy.2013.0427