碘难治性甲状腺癌的诊治进展

多数分化型甲状腺癌(differentiated thyroid cancer，DTC)经过规范的手术、选择性131I治疗及促甲状腺激素抑制治疗后预后良好，然而，仍有部分转移性DTC的患者在早期或131I治疗过程中失去了摄碘能力发展为碘难治性DTC(radioiodine-refractory DTC，RAIR-DTC)。RAIR-DTC病情进展快，死亡率高，为这些患者寻找有效的治疗手段一直是甲状腺癌领域研究的热点。该文对碘难治性甲状腺癌的诊断及治疗进展进行综述，为及早识别这些患者，并为其他可能获益的治疗手段如靶向治疗及放疗等的早期干预争取时间。

Research progress in diagnosis and treatment of radioiodine-refractory differentiated thyroid cancer

Surgery, selective radioiodine therapy and thyroid stimulating hormone suppressive therapy are the standard treatment modalities for differentiated thyroid cancer (DTC). After therapy, most DTC patients could get good prognosis. However, some patients with distant metastasis lose the ability to concentrate radioiodine at early time or during the treatment, and develop radioiodine-refractory DTC (RAIR-DTC). These patients progress quickly and have high mortality. Looking for effective treatments for these patients has been the hot spot in research of thyroid carcinoma. In this paper, we summarized the recent advances in the diagnosis and treatment of RAIR-DTC, hoping to early identify these patients and buy time for early intervention of other possible beneficial treatments such as targeted therapy and radiotherapy.