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甲状腺髓样癌(MTC)患者的血降钙素水平必然升高;有时则须经静脉注射促分泌素或五既促胃酸激素刺激后才有明显升高.因此,血降钙素已被认为是MTC最佳的标记物,临床上常用以作为诊断依据及术后疗效评估指标.若MTC手术切除后.血降钙素继续保持高水平,即提示有肿瘤残留.MTC生长缓慢,常可局限在颈部达数月甚至数年,因此在术后有残留或有局部复发时,仍立考虑再次手术.作者等过去曾为4例肿瘤残留息者作了进一步切除及淋巴清扫手术,使血浆降钙素下降至正常水平.近又对32例相似病例作了再次手术.由于MTC对放疗或化疗均不甚敏感,所以手术治疗的作用更应受重视.1990年11月至1993年4月,作者给32例已经做过甲状腺全切除的MTC患者做了再次手术.其中24例过去并曾做过颈淋巴结清扫术.再次手术的依据为血浆降钙素未下降至正常.
In patients with medullary thyroid carcinoma (MTC), the serum level of calcitonin must increase; sometimes, it will be significantly increased after intravenous infusion of secretagogues or vasopressin stimulation. Therefore, calcitonin has been considered It is the best marker of MTC, and it is commonly used as a diagnostic basis and postoperative therapeutic index in clinical practice. If blood plasma calcitonin continues to maintain a high level after MTC resection, it indicates that there is tumor residue. MTC grows slowly and can often be limited. In the neck several months or even years, so there is residual or local recurrence after surgery, still considering re-operation. The author had in the past for 4 cases of residual tumors were further removed and lymphatic dissection, so that plasma Calcitonin decreased to normal levels. Nearly 32 similar cases were reoperated. Since MTC is not sensitive to radiotherapy or chemotherapy, the role of surgical treatment should be emphasized. From November 1990 to April 1993 The authors performed reoperation on 32 MTC patients who had undergone total thyroidectomy. Of these, 24 patients had previously undergone cervical lymph node dissection. The reoperation was based on the fact that plasma calcitonin did not drop to normal.