中国实用外科杂志2024，Vol.44Issue(6)：701-704,4.DOI:10.19538/j.cjps.issn1005-2208.2024.06.19
甲状腺癌骨转移诊断及治疗
Surgical diagnosis and treatment of bone metastasis in thyroid cancer
摘要
Abstract
The prognosis for bone metastasis in thyroid cancer is relatively poor,with an incidence rate of about 4％,and 70％of patients die within four years of diagnosis.Bone metastasis often causes bone pain,pathological fractures,spinal cord compression syndrome,and hypercalcemia,severely affecting patients'quality of life.Diagnosing bone metastasis in thyroid cancer mainly relies on imaging examinations,including neck ultrasound,enhanced CT,MRI,PET-CT,and bone scanning,which can identify thyroid lesions,the extent of invasion,and bone metastasis.The treatment of bone metastasis in thyroid cancer requires a multidisciplinary approach to develop individualized treatment plans.Treatment methods include surgical treatment,isotope therapy,other treatments,and small molecule targeted therapy.Surgical treatment mainly targets the primary thyroid lesion and bone oligometastatic foci and can involve lesion resection and bone defect reconstruction.Patients with differentiated thyroid cancer bone metastasis can undergo isotope therapy after total thyroidectomy,which requires discontinuation of thyroxine and a low-iodine diet before treatment.Other treatments include bone cement fixation,palliative curettage fixation,radiofrequency or cryoablation,local external radiation,and vascular embolization therapy,which can be used to relieve local symptoms,delay tumor growth,and reduce intraoperative bleeding.In recent years,the development of small-molecule targeted therapy has been rapid,with drugs such as sorafenib,lenvatinib,vandetanib,cabozantinib,and nilotinib widely used for the treatment of advanced thyroid cancer,effectively inhibiting tumor angiogenesis and growth.Studies have shown that factors such as age,gender,race,and marital status are related to the occurrence of bone metastasis in thyroid cancer.Bone metastasis in thyroid cancer increases the occurrence of skeletal-related events(SREs),such as pathological fractures and spinal cord compression,affecting patients'quality of life.Patients with differentiated thyroid cancer bone metastasis often achieve better prognoses through active comprehensive treatment.关键词
甲状腺癌/骨转移/外科治疗/同位素治疗/靶向治疗/诊断/预后/骨骼相关事件Key words
thyroid cancer/bone metastasis/surgical treat-ment/isotope therapy/targeted therapy/diagnosis/prognosis/skeletal-related events分类
医药卫生引用本文复制引用
樊友本,邓先兆,杨庆诚,邱忠领..甲状腺癌骨转移诊断及治疗[J].中国实用外科杂志,2024,44(6):701-704,4.基金项目
国家自然科学基金面上项目(No.81771865) （No.81771865）
上海申康发展中心三年行动计划项目(No.SHDC2020CR6003-002) （No.SHDC2020CR6003-002）
