2025年 韩国甲状腺协会临床管理指南 针对低风险乳头甲状腺癌的积极监测
Eun Kyung Lee1, Min Joo Kim2, Seung Heon Kang3
1Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Endocrinology and metabolism (Seoul, Korea)
|July 2, 2025
概括
积极监测 (AS) 是低风险的乳头甲状腺小癌 (PTMC) 的安全选择. 本指南为AS提供了一个框架,平衡瘤安全与以患者为中心的PTMC管理护理.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 状甲状腺微癌 (PTMC) 的检测越来越多,引发了过度治疗的担忧.
- 积极监测 (AS) 是低风险PTMC的立即手术的替代方案.
- 韩国甲状腺协会制定了PTMC中AS的第一个指导方针.
研究的目的:
- 为在患有低风险乳头甲状腺微癌 (PTMC) 的患者实施主动监测 (AS) 提供结构化的框架.
- 引导临床医生和患者在关于手术与AS的共同决策中进行指导.
- 确保瘤安全,并在PTMC管理中支持以患者为中心的护理.
主要方法:
- 在PTMC中为AS制定多学科小组指导方针.
- 定义了AS资格的标准,包括瘤特征和转移的不存在.
- 建立了基线评估协议 (超声波,可选CT) 和后续时间表.
- 强调了考虑到瘤结果,风险,生活质量和成本的共同决策.
主要成果:
- 建议在没有临床证据表明转移或攻击性特征的Bethesda V-VI PTMC的成年人使用AS.
- 基线评估包括高分辨率的部超声波;对比度增强CT是可选的.
- 随访方案:部超声波和甲状腺功能测试每6个月进行2年,然后每年一次.
- 疾病进展需要手术干预.
结论:
- 该指南为PTMC的安全和以患者为中心的积极监测提供了一个结构化的框架.
- 分享决策对于权衡手术与AS至关重要,考虑到多个患者因素.
- 积极监测对于精心挑选的低风险PTMC患者来说可能是一个可行的选择,减少过度治疗.
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