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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

23卷

期数:

2017年03期

页码:

239-241

栏目:

临床医学

出版日期:

2017-05-18

文章信息/Info

Title:

Study on calcitonin in diagnosis and surgery selection in patients with medullary thyroid cancer

文章编号:

1006-8147(2017)03-0239-03

作者:

宋宁宁¹; 2; 王义增¹; 3 ; 李欣¹; 3; 刘媛超¹; 3; 王新超²; 何向辉³

（1.天津医科大学研究生院，天津300070；2.天津医科大学第四中心临床学院甲状腺乳腺外科，天津300140；3.天津医科大学总医院普通外科，天津300052）

Author(s):

SONG Ning-ning¹; 2;  WANG Yi-zeng¹; 3;  LI Xin¹; 3;  LIU Yuan-chao¹; 3;  WANG Xin-chao² ;  HE Xiang-hui³

(1. Graduate School, Tianjin Medical University, Tianjin 300070, China；2.Department of Thyroid and Breast, Fourth Center Clinical College, Tianjin Medical University, Tianjin 300140, China；3. Department of General Surgery, General Hospital, Tianjin Medical University, Tianjin 300052, China)

关键词:

甲状腺髓样癌; 降钙素; 术中冰冻; 再次手术

Keywords:

medullary thyroid carcinoma; calcitonin; frozen section; reoperation

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分类号:

R653

DOI:

-

文献标志码:

A

摘要:

目的：研究降钙素对甲状腺髓样癌诊断价值和首次术式选择及预后的意义。方法：回顾性分析23例降钙素水平增高案例的临床资料；另收集14例术前未行降钙素检测、术后诊断为甲状腺髓样癌的临床资料，比较降钙素检测对首次术式及预后的影响。结果：术中冰冻出现假阴性的2例术前降钙素水平均增高。同期淋巴结转移与淋巴结未转移相比降钙素水平明显增高。未行降钙素检测导致首次手术不规范而需追加二次手术有7例，病理示残癌率85.7%，颈部淋巴结转移占42.9%，1年内因复发再次手术有4例、高于降钙素检测首次术式规范者。结论：术前降钙素检测对术中冰冻在甲状腺髓样癌诊断上具有提示意义。首次规范术式能够避免近期追加二次手术，并降低复发发生率。

Abstract:

Objective: To analyze value of calcitonin (Ctn) in diagnosis, operation selection and prognosis of thyroid medullary thyroid cancer (MTC). Methods: Clinical data from 23 MTC patients with increased Ctn were analyzedretrospectively. The data from 14 MTC patients without Ctn test were collected for comparing effect of Ctn test on surgery. Results: Two false negative cases by frozen section had an increased Ctn level. Ctn level was significantly higher in patients with lymph node metastasis than without. Seven patients without Ctn test received reoperation due to non-standard first operation and pathology confirmed 85.7% cases with residual tumor and 42.9% cases with lymph node metastasis, and 4 patients received reoperation due to recurrence within 1 year, more thanpatients who received standard first operation. Conclusion: The serum Ctn test may have implications on diagnosis of MTC by frozen section. Standard first operation can decrease rate of reoperation and recurrence.

参考文献/References:

[1]Wells SA Jr, Asa SL, Dralle H, et al. Revised American thyroid association guidelines for the management of medullary thyroid carcinoma[J].Thyroid,2015,25(6):567

[2]Tuttle R M, Ball D W, Byrd D, et al. Medullary carcinoma[J].J NatlComprCanc Netw,2010,8(5):512

[3]Wells S J, Dilley W G, Farndon J A, et al. Early diagnosis and treatment of medullary thyroid carcinoma[J].Arch Intern Med,1985,145(7):1248

[4]Elisei R, Bottici V, Luchetti F, et al. ImpaCtn of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer:experience in 10864 patients with nodular thyroid disorders[J].J ClinEndocrinol Metab,2004,89(1):163

[5]Guesgen C, Willms A, Zwad A, et al. Investigation of FaCtnors potentially influencing calcitonin levels in the screening and Follow-Up for medullary thyroid carcinoma:a cautionary Note[J].BMC Clin Pathol,2013,13(1):27

[6]Kwon H, Kim W G, Choi Y M, et al. A Cut-Off value of basal serum calcitonin for DeteCtning macroscopic medullary thyroid carcinoma[J]. ClinEndocrinol (Oxf),2015,82(4):598

[7]Kloos R T, EngC, Evans D B, et al.Medullary thyroid cancer: management guidelines of the American thyroid association[J]. Thyroid,2009, 19(6):565

[8]Valderrabano P, Klippenstein D L, Tourtelot J B, et al. New American thyroid association sonographic patterns for thyroid nodules perform well in medullary thyroid carcinoma: institutional experience, systematic review, and Meta-Analysis[J].Thyroid,2016,26(8):1093

相似文献/References:

[1]陈立,贾兰宁,王义增,等.基于SEER数据库的甲状腺髓样癌预后分析[J].天津医科大学学报,2021,27(02):167.
　CHEN Li,JIA Lan-ning,WANG Yi-zeng,et al.Prognostic analysis of medullary thyroid carcinoma based on SEER data[J].Journal of Tianjin Medical University,2021,27(03):167.

备注/Memo

备注/Memo:

作者简介? 宋宁宁（1989-），男，硕士在读，研究方向：普通外科；通信作者：何向辉，E-mail：hxhe0100@163.com。

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更新日期/Last Update: 2017-05-18