摘要
局部进展期甲状腺癌(LATC)是甲状腺癌病人的主要死亡与复发原因之一。目前评价LATC预后的主要方法是TNM分期和美国甲状腺学会(ATA)复发危险分层。研究结果显示,LATC侵犯喉返神经增加复发风险,但不影响生存。而LATC侵犯气管、喉、食管以及颈部、上纵隔血管时,则应根据侵犯的具体深度来判断其对预后的影响。BRAFV600E和TERT启动子的共同突变在LATC的预后判断中具有重要价值。建立更为精准的LATC临床及分子标记物预后评价体系,必将提高LATC手术疗效,使病人获益。
Locally advanced thyroid cancer(LATC)is one of the leading causes of death and postoperative recurrence in thyroid cancer patients.The main methods to evaluate the prognosis of LATC are TNM staging and American Thyroid Society(ATA)risk stratification for recurrence.When LATC invaded the recurrent laryngeal nerve,the risk of tumor recurrence was higher,but there was no effect on survival time.LATC invades the trachea,larynx,esophagus,neck,and upper mediastinal vessels,judged the impact on prognosis according to the specific degree of invasion.Synergetic mutations of BRAFV600E and TERT promoters are associated with aggressive clinicopathologic features and an increased risk of recurrence and mortality and may help to predict aggressive behavior of LATC and to assist in clinical decision-making.The establishment of a more accurate prognosis evaluation system for clinical and molecular markers of LATC will undoubtedly improve the efficacy of LATC surgery and benefit patients.
作者
张浩
常煜昂
ZHANG Hao;CHANG Yu-ang(Department of Thyroid Surgery,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)
出处
《中国实用外科杂志》
CAS
CSCD
北大核心
2023年第8期881-883,共3页
Chinese Journal of Practical Surgery
基金
辽宁省应用基础研究计划项目(No.2022020225-JH2/1013)。
关键词
局部进展期甲状腺癌
预后
评价
locally advanced thyroid cancer
prognosis
evaluation
