| 赵丹,张晓梅.低风险甲状腺微小乳头状癌积极监测的研究进展[J].中国临床保健杂志,2022,25(6):740-744. |
| 低风险甲状腺微小乳头状癌积极监测的研究进展 |
| Advances in active surveillance treatment for low-risk papillary thyroid micro carcinoma |
| 投稿时间：2022-08-08 |
| DOI：10.3969/J.issn.1672-6790.2022.06.005 |
| 中文关键词: 甲状腺肿瘤 癌,乳头状 监测,生理学 临床决策 |
| 英文关键词: Thyroid neoplasms Carcinoma,papillary Monitoring,Physiologic Clinical decision-making 〖FL |
| 基金项目:北京大学国际医院重点基金项目(YN2016ZD01；YN2019ZD04) |
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| 中文摘要: |
| 如何管理低风险甲状腺微小乳头状癌(PTMC)的患者已经成为一个重要的临床问题。由于低风险PTMC的预后良好且发病率相对较高,对于寻求平衡长期生存率和过度治疗的潜在不良影响的患者来说,积极监测(AS)的决策可能比立即手术更可取。AS已经被确立为低风险PTMC患者的标准管理策略之一,在全球范围内被逐渐采用,然而并不是所有的PTMC都适合采用AS。关于AS风险和获益的客观证据有限,在临床决策中还需同时考虑到肿瘤的特点和患者的心理状况,许多医生仍然在AS和立即手术之间犹豫不决。从最初的评估到制定治疗决策,了解并建立适当的AS方案非常重要。该文总结了AS的临床研究结果、研究成就和不足以及AS的最佳适应证和随访策略,并探讨了AS未解决的问题。 |
| 英文摘要: |
| How to manage patients with low-risk papillary thyroid micro-carcinoma (PTMC) has now become an important clinical issue.Because of the good prognosis and relatively high incidence of low-risk PTMC,active surveillance (AS) treatment decisions may be preferable to immediate surgery for patients seeking to balance long-term survival with the potential adverse effects of over-treatment.Due to the limited objective evidence on the risks and benefits of AS and the need to consider both tumor characteristics and patient psychological status in clinical decision making,many physicians are still hesitant between AS and immediate surgery.It is important to understand and establish appropriate AS protocols from the initial evaluation to the development of treatment decisions.In this review,we will summarize the clinical outcomes of AS in previous studies,research achievements and shortcomings,as well as the optimal indications and follow-up strategies for AS,and discuss unresolved issues regarding AS. |
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