甲状腺微小乳头状癌术前诊断的研究进展
Advances in Preoperative Diagnosis of Papillary Thyroid Microcarcinoma
DOI: 10.12677/ACM.2022.126722, PDF,   
作者: 王亚茜:青海大学研究生院,青海 西宁;王晓武*, 马志军:青海大学附属医院乳腺甲状腺肿瘤外科,青海 西宁
关键词: 甲状腺微小乳头状癌术前诊断影像学检查基因检测Papillary Thyroid Microcarcinoma Preoperative Diagnosis Imaging Examination Gene Detection
摘要: 甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)早期易发生淋巴结转移,增加了肿瘤复发的风险,是影响患者预后的独立危险因素,且影响手术方式及术后综合方案的制定,因此早期发现及诊断对其具有重要意义。常用的术前诊断方法包括超声、超声造影、超声引导下细针穿刺活检(US-FNAB)、CT等,BRAF基因检测作为近几年新出现的检查手段,很大程度上提高了PTMC的术前诊断率。本文对不同的术前诊断方法作一综述,为临床合理选择辅助检查提供参考。
Abstract: Papillary thyroid microcarcinoma (PTMC) is prone to lymph node metastasis in the early stage, which increases the risk of tumor recurrence, is an independent risk factor affecting the prognosis of patients, and affects the mode of operation and the formulation of postoperative comprehensive plan, so early detection and diagnosis are of great significance. The commonly used preoperative diagnosis methods include ultrasound, contrast-enhanced ultrasound, ultrasound-guided fine nee-dle biopsy (US-FNAB), CT and so on. As a new examination method in recent years, BRAF gene de-tection has greatly improved the preoperative diagnosis rate of PTMC. This article reviews different preoperative diagnostic methods in order to provide reference for clinical reasonable selection of auxiliary examination.
文章引用:王亚茜, 王晓武, 马志军. 甲状腺微小乳头状癌术前诊断的研究进展[J]. 临床医学进展, 2022, 12(6): 4983-4988. https://doi.org/10.12677/ACM.2022.126722

参考文献

[1] 郭晶晶, 薛恩生, 俞丽云, 梁荣喜, 杨嘉嘉, 陈舜. 不同大小及位置甲状腺微小乳头状癌纵横比与被膜侵犯的关系[J]. 中国医学影像技术, 2018, 34(6): 850-854. [Google Scholar] [CrossRef
[2] Horvath, E., Majlis, S., Rossi, R., et al. (2009) An Ultrasonogram Reporting System for Thyroid Nodules Stratifying Cancer Risk for Clinical Management. The Journal of Clinical Endocrinology & Metabolism, 94, 1748-1751. [Google Scholar] [CrossRef] [PubMed]
[3] Kwak, J.Y., Han, K.H., Yoon, J.H., et al. (2011) Thyroid Imaging Re-porting and Data System for US Features of Nodules: A Step in Establishing Better Stratification of Cancer Risk. Radi-ology, 260, 892-899. [Google Scholar] [CrossRef] [PubMed]
[4] Yang, C., Han, C., Wang, L.-P., et al. (2013) Exploration on an Ul-trasonographic Imaging Reporting and Data System in Malignancy Grading of Thyroid Nodules. Chinese Journal of Oncology, 35, 758-763.
[5] Roy, S.G., Tripathy, S., Parida, G.K., et al. (2018) A Rare Case of Synchronous Papillary Microcarcinoma and Metastatic Neuroendocrine Tumor of Unknown Primary. Indian Journal of Nuclear Medicine, 33, 59-61.
[6] Januś, D., Wójcik, M., Drabik, G., et al. (2018) Ultrasound Variants of Autoimmune Thyroiditis in Children and Adolescents and Their Clinical Implication in Relation to Papillary Thyroid Carcinoma Development. Journal of En-docrinological Investigation, 41, 371-380. [Google Scholar] [CrossRef] [PubMed]
[7] Oh, H.-S., Park, S., Kim, M., et al. (2017) Young Age and Male Sex Are Predictors of Large-Volume Central Neck Lymph Node Metastasis in Clinical N0 Papillary Thyroid Microcarcinomas. Thyroid, 27, 1285-1290. [Google Scholar] [CrossRef] [PubMed]
[8] Trapanese, E., De Bartolomeis, C., Angrisani, B., et al. (2018) Papillary Thyroid Microcarcinoma (Black Ink). Oncotarget, 9, 29275-29283. [Google Scholar] [CrossRef] [PubMed]
[9] 谭妍迪, 赵云, 周军, 刘朝奇, 李明阳. 常规超声联合超声弹性成像对甲状腺微小乳头状癌诊断价值的Meta分析[J]. 中国普通外科杂志, 2019, 28(5): 565-572.
[10] Wang, H.L., Zhao, L.H., Xin, X.J., et al. (2014) Diagnostic Value of Elastosonography for Thyroid Microcarcinoma. Ultrasonics, 54, 1945-1949. [Google Scholar] [CrossRef] [PubMed]
[11] 杨志芳, 詹维伟, 周建桥. 超声对桥本甲状腺炎甲状腺微小乳头状癌的诊断价值[J]. 中华医学超声杂志(电子版), 2014, 11(10): 840-844.
[12] 霍晓明, 张红, 冯海洋, 李逢生, 赵冬丽. 弹性成像与超声造影联合应用诊断甲状腺微小乳头状癌的价值[J]. 现代肿瘤医学, 2016, 24(15): 2462-2465.
[13] Li, F., Zhang, J., Wang, Y. and Liu, L. (2015) Clinical Value of Elasticity Imaging and Con-trast-Enhanced Ultrasound in the Diagnosis of Papillary Thyroid Microcarcinoma. Oncology Letters, 10, 1371-1377. [Google Scholar] [CrossRef] [PubMed]
[14] 冯蓉, 安丽, 张建蕾, 景磊. 超声造影联合弹性成像对甲状腺微小乳头状癌的诊断价值研究[J]. 中国肿瘤临床与康复, 2020, 27(12): 1436-1439. [Google Scholar] [CrossRef
[15] 甲状腺癌诊疗规范(2018年版) [J]. 中华普通外科学文献(电子版), 2019, 13(1): 1-15.
[16] Ali, S.Z. and Cibas, E.S. (2010) The Bethesda System for Reporting Thyroid Cyto-pathology: Definitions, Criteria and Explanatory Notes. Springer US, Beijing, 1-3. [Google Scholar] [CrossRef
[17] Lin, K.L., Xiang, Y.Y., Qiao, L., et al. (2015) A Predictive Model for Selecting Malignant Thyroid Nodules in Patients with Nondiagnostic or Indeterminate Fine-Needle Aspiration Cyto-logic Findings. Journal of Ultrasound in Medicine, 34, 1245-1251. [Google Scholar] [CrossRef] [PubMed]
[18] Unal, B. and Sezer, C. (2014) Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules. Asian Pacific Journal of Cancer Prevention, 15, 8613-8616. [Google Scholar] [CrossRef
[19] 李春风, 潘平, 纪元, 王海涛, 孙兆男, 幕转转, 王丽君. 46例甲状腺微小乳头状癌的CT征象分析[J]. 大连医科大学学报, 2017, 39(3): 242-246.
[20] 段文飞, 姜文官, 李晶, 赵武, 宋瑶. B超、CT、MRI对甲状腺微小癌的诊断意义[J]. 中国医药导报, 2015, 12(25): 129-132.
[21] Tanpitukpongse, T.P., Grady, A.T., Sosa, J.A., et al. (2015) Incidental Thyroid Nodules on CT or MRI: Discordance between What We Report and What Receives Workup. AJR. American Journal of Roentgenology, 205, 1281-1287. [Google Scholar] [CrossRef
[22] Khizer, A.T., Raza, S. and Slehria, A.U. (2015) Diffusion-Weighted MR Imaging and ADC Mapping in Differentiating Benign from Malignant Thyroid Nodules. Journal of College of Phy-sicians and Surgeons Pakistan, 25, 785-788.
[23] 张波涛, 蔡婵艳. 甲状腺微小癌采用MRI、CT、B超三种检测方式对其诊断效果的对比分析[J]. 中国CT和MRI杂志, 2017, 15(5): 43-44+77.
[24] Hu, S.D., Zhang, H., Zhong, Y.Q., et al. (2022) Assessing Diagnostic Value of Combining Ultrasound and MRI in Extrathyroidal Extension of Papil-lary Thyroid Carcinoma. Cancer Management and Research, 14, 1285-1292. [Google Scholar] [CrossRef
[25] 王欢, 何涛, 李叔俊. 18F-FDG-PET-CT在分化型甲状腺癌诊断、分期判定及预后判定中的价值探讨[J]. 中国CT和MRI杂志, 2021, 19(6): 52-54.
[26] 孙丽昕, 王荣福. PET/CT在甲状腺癌的临床应用进展[J]. 肿瘤学杂志, 2017, 23(6): 470-473.
[27] Virk Renu, K., Van Dyke Alison, L., Finkelstein, A., et al. (2013) BRAFV600E Mutation in Papillary Thyroid Microcarcinoma: A Genotype-Phenotype Cor-relation. Modern Pathology, 26, 62-70. [Google Scholar] [CrossRef] [PubMed]
[28] Ferris, R.L., Baloch, Z., Bernet, V., et al. (2015) American Thy-roid Association Statement on Surgical Application of Molecular Profiling for Thyroid Nodules: Current Impact on Peri-operative Decision Making. Thyroid, 25, 760-768. [Google Scholar] [CrossRef] [PubMed]
[29] Xing, M.Z. (2013) Molecular Pathogenesis and Mechanisms of Thy-roid Cancer. Nature Reviews Cancer, 13, 184-199. [Google Scholar] [CrossRef] [PubMed]
[30] Kurtulmus, N., Ertas, B., Saglican, Y., et al. (2016) BRAF Mutation: Has It a Role in Cervical Lymph Node Metastasis of Papillary Thyroid Cancer? European Thyroid Journal, 5, 195-200. [Google Scholar] [CrossRef] [PubMed]
[31] 苏静君, 曾婵娟, 范春磊, 苏国强. BRAF V600E基因突变检测对甲状腺微小癌的诊断价值[J]. 中国卫生标准管理, 2018, 9(23): 44-47.
[32] Kwak, J.Y., Kim, E.-K., Chung, W.Y., et al. (2009) Association of BRAFV600E Mutation with Poor Clinical Prognostic Factors and US Features in Korean Patients with Papillary Thyroid Microcarcinoma. Radiology, 253, 854-860. [Google Scholar] [CrossRef] [PubMed]
[33] Chung, K.-W., Yang, S.K., Lee, G.K., et al. (2006) Detection of BRAFV600E Mutation on Fine Needle Aspiration Specimens of Thyroid Nodule Refines Cyto-Pathology Diagnosis, Especially in BRAF600E Mutation-Prevalent Area. Clinical Endocrinology, 65, 660-666. [Google Scholar] [CrossRef] [PubMed]
[34] Adeniran, A.J., Hui, P., Chhieng, D.C., et al. (2011) BRAF Mutation Testing of Thyroid Fine-Needle Aspiration Specimens Enhances the Predictability of Malignancy in Thyroid Follicular Lesions of Undetermined Significance. Acta Cytologica, 55, 570-575. [Google Scholar] [CrossRef] [PubMed]
[35] Chen, B.D., Zhang, Z., Wang, K.K., et al. (2019) Association of BRAF V600E Mutation with Ultrasonographic Features and Clinicopathologic Characteristics of Papillary Thyroid Microcarci-noma: A Retrospective Study of 116 Cases. Clinical Hemorheology and Microcirculation, 73, 545-552. [Google Scholar] [CrossRef
[36] 白智群, 黄崑, 王学梅. 细针穿刺活检联合BRAF V600E基因检测对甲状腺微小癌诊断的临床价值[J]. 中国医科大学学报, 2020, 49(7): 667-669.