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在2302名对初级疗法反应良好的患者中,差异化甲状腺癌复发的频率

Iwona Pałyga^1,2, Maciej Rumian¹, Alicja Kosel¹

¹Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.

The Journal of clinical endocrinology and metabolism

|September 28, 2023

概括

差异化甲状腺癌 (DTC) 的真正复发是罕见的,特别是在乳头甲状腺癌 (PTC) 患者中,最初反应良好. 一些DTC亚型和淋巴结转移的DTC亚型需要持续的随访.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
手术瘤学手术瘤学

背景情况:

有关差异化甲状腺癌 (DTC) 复发率存在不一致的数据.
了解对初始治疗反应良好的患者的复发模式对于优化后续治疗策略至关重要.

研究的目的:

评估DTC患者真正复发的频率和风险因素,这些患者在初始治疗中获得了出色的反应 (ExR).
确定可能从持续的瘤监测中受益的特定患者子组.

主要方法:

对2302名连续DTC患者的回顾性分析,在24年内在一个中心获得ExR至初级治疗.
对复发率,累积复发率 (CRR) 和相关风险因素的分析,特别是对乳头甲状腺癌 (PTC) 的分析.
评估用于检测复发的诊断方法.

主要成果:

在1.4% (32/2302) 的DTC患者中观察到真正的复发.
患有复发的PTC患者与年轻的年龄,更大的瘤大小,淋巴结转移,不完全切除,更高的ATA风险和先前的131I治疗有关.
累计复发率 (CRR) 仍然很低,达到24年2.9%的峰值. 差分化甲状腺癌 (PDTC) 的CRR最高,而PTC的CRR最低. 大多数复发发生在5年内. 精细针吸收细胞学和18F-FDG PET的超声波分别对局部和远程复发检测有效.

结论:

真正的DTC复发是罕见的,特别是在PTC患者中,最初的反应很好,没有淋巴结转移 (N0/Nx),可能会考虑从瘤随访中解雇.
患有淋巴结转移 (N1) 的DTC患者或患有PDTC,瘤性甲状腺癌 (OTC) 和卵泡性甲状腺癌 (FTC) 亚型的DTC患者,即使初始反应良好,也需要继续进行瘤监测.

关键词:

在DTC中,我们可以使用DTC.复发性复发性复发性甲状腺癌是甲状腺癌.

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