摘要
分化型甲状腺癌(DTC)在全部甲状腺癌类型中最为常见,占94％以上.目前主要采取根治性手术切除、选择性放射(131I)治疗和促甲状腺激素(TSH)抑制治疗的综合治疗,总体预后较好.TSH能够与DTC细胞表达的TSH受体结合,刺激DTC细胞生长,因此TSH抑制治疗是减少DTC患者术后肿瘤复发风险的重要环节,已得到国内外多项指南的明确推荐.但在临床实践中,仍存在部分患者难以实现TSH抑制治疗目标,需要反复调整治疗剂量以达到预期目标,治疗过程中可能伴随乏力、嗜睡或心悸等不适.本文主要总结DTC术后TSH抑制治疗疗效的影响因素,以期帮助临床医生为DTC患者提供更好的术后TSH抑制治疗和随访管理,以提高患者生活质量,延长远期生存时间,降低DTC术后复发率.
Abstract
Differentiated thyroid cancer(DTC)is the most common type of thyroid cancer,accounting for over 94％of cases.Currently,the main treatments include radical surgical resection,selective radioiodine(131I)therapy,and thyroid-stimulating hormone(TSH)suppression therapy,with generally good overall prognosis.TSH can bind to TSH receptors expressed by DTC cells,stimulating their growth.Therefore,TSH suppression therapy is a crucial step in reducing the risk of tumor recurrence in DTC patients after surgery,and it has been clearly recommended by multiple guidelines both at home and abroad.However,in clinical practice,some patients still find it difficult to achieve the TSH suppression therapy goals,requiring repeated adjustments of the treatment dose to reach the desired targets.During the treatment process,patients may experience discomfort such as fatigue,drowsiness,or palpitations.This article mainly summarizes the factors influencing the efficacy of TSH suppression therapy after DTC surgery,aiming to help clinicians provide better postoperative TSH suppression treatment and follow-up management for DTC patients,thereby improving their quality of life,extending long-term survival,and reducing postoperative recurrence rates of DTC.
基金项目
浙江省基础公益研究基金资助项目(LGF22H070008)
浙江省医药卫生科技基金资助项目(2021KY850)
浙江省医药卫生科技基金资助项目(2022KY675)
浙江省杭州市医药卫生科技基金资助项目(0020191087)
国家科技期刊平台
NSTL
万方数据