甲状腺髓样癌术前系统性评估的"七步法"OA
The Seven-Step preoperative systematic assessment for medullary thyroid carcinoma
甲状腺髓样癌(MTC)是一种预后相对较差、易早期转移且对常规放化疗不敏感的神经内分泌肿瘤,其治疗成效高度依赖于初次手术的彻底性.本文结合临床实践经验与现有循证依据,围绕MTC的病理生理及临床特征,梳理并总结出一套结构化的术前评估"七步法".该流程系统整合了生化检测、病理确诊、影像分期、遗传筛查、共存病排查、手术规划及风险预判,旨在通过系统化的术前准备,提升初始治疗的精准性,为临床应对此类疾病提供一套可参考的评估路径与决策思路,以期优化治疗结局、改善患者预后.
Medullary thyroid carcinoma(MTC)is a neuroendocrine malignancy characterized by a relatively poor prognosis,a high propensity for early metastasis,and limited sensitivity to conventional chemotherapy and radiotherapy.Clinical outcomes largely depend on the completeness of the initial surgical intervention.Based on the pathophysiological and clinical characteristics of MTC,this review proposes a structured"seven-step"preoperative assessment strategy.This systematic approach integrates biochemical e-valuation,pathological confirmation,imaging-based staging,genetic screening,assessment of coexisting conditions,surgical plan-ning,and perioperative risk stratification.The aim is to address current gaps in diagnosis and management through precise initial treat-ment,thereby providing clinicians with a comprehensive and orderly assessment framework to guide radical tumor resection,minimize the need for reoperation,and ultimately improve patient prognosis.
周倩蕾;申宇昕;魏瑾晨;龙淼云
中山大学第六附属医院普通外科(甲状腺外科),广东省结直肠盆底疾病研究重点实验室,中山大学第六附属医院生物医学创新研究院(广东 广州 510510)中山大学孙逸仙纪念医院甲状腺外科(广东 广州 510120)中山大学第六附属医院普通外科(甲状腺外科),广东省结直肠盆底疾病研究重点实验室,中山大学第六附属医院生物医学创新研究院(广东 广州 510510)中山大学第六附属医院普通外科(甲状腺外科),广东省结直肠盆底疾病研究重点实验室,中山大学第六附属医院生物医学创新研究院(广东 广州 510510)
医药卫生
甲状腺髓样癌病理确诊遗传筛查初始治疗手术规划
medullary thyroid carcinomapathological confirmationgenetic screeninginitial treatmentsurgical planning
《广东医学》 2026 (2)
161-165,5
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