甲状腺癌临床指南解读ppt课件.ppt

五、未来的研究方向 * 华中科技大学附属协和医院乳腺甲状腺外科 * 1、新型疗法和临床试验 靶向治疗新药二期临床已经显示一定疗效 axitinib motesanib sorafenib pazopanib 沙利度胺 初步疗效显示以PR+SD为主。 * 华中科技大学附属协和医院乳腺甲状腺外科 * 2、其他研究 致癌信号途径抑制因子 生长或凋亡调节剂 血管生成抑制剂 免疫调节剂 基因疗法 RAI的长期风险 Tg持续低水平的临床重要性 Tg抗体问题 小淋巴结转移 风险分层的改良 * 华中科技大学附属协和医院乳腺甲状腺外科 * Newly Detected and Fatal Cases of Thyroid Cancer. These graphs show the percentage of new cases and deaths caused by carcinomas arising from thyroid follicular cells (ie, excluding lymphoma and medullary carcinomas).1 Hürthle cell cancer is a subtype of follicular cancer.2 Because anaplastic thyroid cancer has a high mortality rate, many clinicians assume that most deaths from thyroid cancer are caused by these aggressive variants of thyroid cancer.3 However, because more new cases of PTC and FTC are diagnosed each year than other types of thyroid cancer, the majority of thyroid cancer deaths occur in patients initially diagnosed with these cancers.4 This is true despite the fact that PTC and FTC have 10-year disease-specific mortality rates of less than 10%.5 Long-term follow-up is required in all patients with thyroid cancer in order to detect the disease at an early stage and minimize the risk of death.2 References 1. Robbins R, et al. Adv Intern Med. 2001;46:277-294. 2. Detailed guide: thyroid cancer. American Cancer Society Web site. Available at: /docroot/CRI/CRI_2_3x.asp?dt=43. Accessed December 10, 2003. 3. Types of thyroid cancer. Virginia Masen Medical Center Web site. Available at: /dbCancer/sec180604.htm. Accessed December 10, 2003. 4. Incidence and prevalence. Thyroid Community Web site. Available at: /hcp/disease/tc_eng_hc_about_incidence.asp. Accessed December 10, 2003. 5. Mazzaferri EL, et al. J Clin Endocrinol Metab. 2003;86:1447-11463. Thyroid Cancer Risk Stratification. Characteristics of the patient and the thyroid cancer can be used to estimate risk of recurrence and risk of disease-specific death.1 In patients younger than 45 years of age, thyroid tumors that are 1 to 2 cm in size, c