散发性甲状腺髓样癌规范手术与非规范手术的效果比较

目的探究规范手术与非规范手术在散发性甲状腺髓样癌(MTC)治疗中的应用效果及预后。方法选取2013年1月至2014年6月收治的散发性MTC患者87例为研究对象,根据手术方式分为对照组(42例)和观察组(45例),对照组采取非规范化手术治疗,观察组采取规范化手术治疗,比较两组术后临床效果及预后。结果两组治疗后降钙素、癌胚抗原水平均较治疗前显著降低,且治疗后观察组显著低于对照组,差异有统计学意义(P<0.01)。观察组和对照组术后并发症发生率比较差异无统计学意义(6.67%vs 7.14%,χ²=0.113,P>0.05)。对照组术后5年生化治愈率显著低于观察组(69.05%vs 97.78%,χ²=13.280,P<0.01),5年复发率显著高于观察组(30.95%vs 2.22%,χ²=13.280,P<0.01)。结论规范化手术治疗散发性MTC患者,可改善血清降钙素、癌胚抗原水平,提升5年生化治愈率,降低复发率,且不会导致术后并发症增加。

Standard operation versus non-standard operation for sporadic medullary thyroid carcinoma

Objective To compare the application effects and prognosis of standard operation(total thyroidectomy with central lymph node dissection)and non-standard operation in the patients with sporadic medullary thyroid carcinoma(MTC).Methods Eighty-seven patients with sporadic MTC admitted to hospital from January 2013 to June 2014 were selected as the research objects and divided into control group(n=42)and observation group(n=45)according to operation mode.Non-standardized surgery was performed in control group,and standardized surgery was conducted in observation group.The clinical effect and prognosis were compared after operation between two groups.Results After treatment,the levels of calcitonin and carcinoembryonic antigen(CEA)significantly decreased in two groups compared with those before surgery and were significantly lower in observation group than those in control group(P<0.01).There was no significant difference in the incidence of postoperative complications between observation group and control group(6.67%vs 7.14%,χ²=0.113,P>0.05).The 5-year biochemical cure rate in control group was significantly lower than that in observation group(69.05%vs 97.78%,χ²=13.280,P<0.01),and the 5-year recurrence rate was significantly higher than that in observation group(30.95%vs 2.22%,χ²=13.280,P<0.01).Conclusion For the patients with sporadic MTC,standardized surgical treatment can reduce the serum calcitonin and CEA levels and the recurrence rate,increase the 5-year biochemical cure rate without increasing postoperative complications.