[Progression of diagnosis and treatment of medullary thyroid carcinoma].

Objective: To review and summarize recent update on preoperative diagnostic criteria, treatment and postoperative follow-up for medullary thyroid carcinoma. Methods: The relevant literatures and guidelines about medullary thyroid carcinoma were analyzed and summarized. Results: In the early stages of the disease radical surgery still dominated. Ultrasound results suggested that prophylactic lateral neck dissection was required for patients with high risk factors or high levels of carcinoembryonic antigen and calcitonin need prophylactic. Early hereditary medullary carcinoma could receive prophylactic thyroidectomy based on RET gene test results. Advanced progressive medullary thyroid carcinoma could be treated with palliative surgery,molecular targeted drugs and chemotherapy. Conclusions: The prognosis of medullary thyroid carcinoma is poor and lymph node metastasis is easy to occur early. The extent of initial operation should be enough. Locally advanced or distant metastatic medullary thyroid carcinoma can be treated with palliative surgery,molecular targeted drugs and chemotherapy.目的： 总结近年来关于甲状腺髓样癌的术前诊断标准、治疗方式和术后随访的更新。 方法： 查阅甲状腺髓样癌相关文献及指南，进行回顾性分析和总结。 结果： 疾病早期阶段根治性手术治疗仍占主要地位，超声提示肿瘤存在高危因素或检测出高水平血清癌胚抗原、降钙素的患者需要进行预防性侧颈淋巴清扫术；遗传性髓样癌可以根据RET原癌基因的检测结果，在疾病早期进行预防性甲状腺切除。晚期进展性甲状腺髓样癌可采用姑息性手术、分子靶向药物和化学治疗方式。 结论： 甲状腺髓样癌预后较差，易早期发生淋巴转移，因此，第一次手术切除的范围应该尽量扩大；局部晚期或远处转移性甲状腺髓样癌可以采用姑息性手术、分子靶向药物、化学治疗等治疗方式。.