武汉甲康医院王宗春专家科普：得了甲状腺乳头状癌还能活几年？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺乳头状癌发病率逐年攀升，<span style="color: black;">非常多</span>人一旦查出癌症，就觉得自己活不长了，干脆不治了。其实，即便患上癌症，要是能做到这5点，<span style="color: black;">能够</span>和未患癌人群<span style="color: black;">同样</span>，安然度过<span style="color: black;">将来</span>的几十年</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">得了甲状腺乳头状癌还能活几年？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">临床上，甲状腺癌，尤其是<span style="color: black;">平常</span>的甲状腺乳头状癌的五年存活率和十年存活率高达90%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">临床治愈<span style="color: black;">指的是</span>在术后一段时间后，指标<span style="color: black;">状况</span><span style="color: black;">非常</span>稳定，<span style="color: black;">能够</span>被<span style="color: black;">叫作</span>为临床治愈。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">术后五年到十年是甲状腺癌的<span style="color: black;">恢复</span>期。要<span style="color: black;">连续</span>观察五年到十年，<span style="color: black;">才可</span><span style="color: black;">保证</span>达到临床治愈标准。而不是治疗一两年，觉得<span style="color: black;">无</span>什么问题了就宣<span style="color: black;">叫作</span>临床治愈了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>能够理性地对待甲状腺乳头状癌的治疗和<span style="color: black;">恢复</span>疗养，术后30-40年存活率达到80%-90%<span style="color: black;">亦</span>是可能实现的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q4.itc.cn/images01/20240403/04145af884914ff98b0fa7875b2f4021.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">指标<span style="color: black;">这般</span><span style="color: black;">寓意</span>着<span style="color: black;">恢复</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1.血象稳定</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">白细胞在<strong style="color: blue;">6～6.5</strong>以上是健康数值，</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中性粒细胞在<strong style="color: blue;">4.0</strong>以上；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">血小板在<strong style="color: blue;">200--230</strong><span style="color: black;">上下</span>，</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">红细胞在<strong style="color: blue;">4.2</strong>以上；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">血红蛋白，女性在<strong style="color: blue;">135</strong>以上，男性则<span style="color: black;">必须</span>到<strong style="color: blue;">140</strong>以上。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q6.itc.cn/images01/20240403/c9ac1e912b39462081da1969231364c4.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">2.肿瘤标志物</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">（1）TSH值</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">低危型<span style="color: black;">病人</span>TSH值维持在<strong style="color: blue;">0.1-0.5</strong>之间，而中高危型<span style="color: black;">病人</span>TSH指标<span style="color: black;">不可</span>高于<strong style="color: blue;">0.1</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">（2）Tg、TgAb</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Tg和TgAb指标的观察仅限于全切<span style="color: black;">病人</span>，对次全切及半切<span style="color: black;">病人</span>参考<span style="color: black;">道理</span>不大</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">tg即甲状腺球蛋白，是甲状腺癌术后观察的密切指标。<span style="color: black;">针对</span>经手术和放射碘治疗后的甲状腺癌<span style="color: black;">病人</span>，血清甲状腺球蛋白<span style="color: black;">针对</span>监测甲状腺癌的复发，和转移<span style="color: black;">拥有</span>高度的<span style="color: black;">敏锐</span>性和特异性。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">血清甲状腺球蛋白，分为<span style="color: black;">基本</span>甲状腺球蛋白测定和Tsh刺激后甲状腺球蛋白的测定，<span style="color: black;">倘若</span>甲状腺球蛋白的<span style="color: black;">基本</span>值超过<strong style="color: blue;">1ng/mL</strong>，Tsh刺激后超过<strong style="color: blue;">2ng/mL</strong>，说明有复发的可能，应该<span style="color: black;">导致</span><span style="color: black;">重视</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>术后Tg<span style="color: black;">无</span><span style="color: black;">上升</span>，而TgAb<span style="color: black;">上升</span>，<span style="color: black;">亦</span>要<span style="color: black;">警觉</span>。<span style="color: black;">由于</span>TgAb是针对Tg的抗体，该抗体<span style="color: black;">上升</span>，说明Tg指标<span style="color: black;">提升</span>，<span style="color: black;">亦</span>有复发的可能。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/images01/20240403/13d86b489f354e42bfaa3197f489009b.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">复查<span style="color: black;">重视</span>这些指标</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1.<span style="color: black;">定时</span><span style="color: black;">检测</span>甲状腺癌复发指标</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>复发<span style="color: black;">危害</span>（高危、中危、低危），把促甲状腺激素TSH<span style="color: black;">控制</span>到相应水平（＜0.1或0.1~0.5或0.5~2），<span style="color: black;">能够</span>有效预防甲状腺癌的复发或转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span><span style="color: black;">病人</span>要问，我的<span style="color: black;">大夫</span>没让我把TSH值<span style="color: black;">掌控</span>在0.1以下啊。这是<span style="color: black;">由于</span>，TSH＜0.1以后，就属于甲亢状态了，<span style="color: black;">长时间</span>的甲亢状态会<span style="color: black;">引起</span>心脏病、骨质疏松等问题，<span style="color: black;">因此</span><span style="color: black;">倘若</span>肿瘤复发<span style="color: black;">危害</span>不是那么高的人，<span style="color: black;">不必</span>把TSH<span style="color: black;">掌控</span>得太低</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">那样</span><span style="color: black;">大夫</span>是怎么<span style="color: black;">评定</span>某个<span style="color: black;">病人</span>的复发<span style="color: black;">危害</span>呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">①手术范围：是全切/左侧切除/右侧切除</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">②手术病理结果：良恶性/<span style="color: black;">可否</span>乳头状癌活特殊病理类型/癌灶个数和<span style="color: black;">体积</span>/有<span style="color: black;">没</span>淋巴结转移/转移个数/<span style="color: black;">可否</span>侵犯甲状腺包膜、<span style="color: black;">周边</span>神经、肌肉、血管/<span style="color: black;">可否</span>有肺部、骨转移。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">③术后几年/有<span style="color: black;">无</span>做过碘-131治疗/<span style="color: black;">近期</span>一次<span style="color: black;">检测</span>的颈部超声、甲状腺功能、甲状腺球蛋白Tg/甲状腺球蛋白抗体TgAb指标</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">④<span style="color: black;">日前</span><span style="color: black;">吃下</span><span style="color: black;">那些</span><span style="color: black;">药品</span>/药量</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">可否</span>有心脏病、骨质疏松病史/女性<span style="color: black;">病人</span><span style="color: black;">可否</span><span style="color: black;">已然</span>绝经/服药后有<span style="color: black;">没</span>心慌、失眠等不适症状</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">定时</span>复查是甲癌<span style="color: black;">病人</span>预防复发的有效<span style="color: black;">办法</span>。但<span style="color: black;">非常多</span><span style="color: black;">病人</span>就诊时，做了<span style="color: black;">有些</span><span style="color: black;">不必</span>的<span style="color: black;">检测</span>，浪费了时间和经历。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/images01/20240403/54756d584e19442d909b1a42462858a7.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">①单叶切除术后复查了甲状腺球蛋白</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺球蛋白检测是检测甲癌复发的指标，单叶切除后，另<span style="color: black;">一边</span>甲状腺还会分泌甲状腺球蛋白，<span style="color: black;">仅有</span>全切<span style="color: black;">病人</span>才<span style="color: black;">必须</span>做甲状腺球蛋白检测。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">②电解质<span style="color: black;">检测</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">术后<span style="color: black;">倘若</span><span style="color: black;">无</span>手脚麻木的<span style="color: black;">状况</span>，<span style="color: black;">能够</span>不查总钙和离子钙，<span style="color: black;">亦</span><span style="color: black;">不必</span>查电解质。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q1.itc.cn/images01/20240403/f0dbeb69c6214dac9b017a232d536a8f.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">发掘</span>甲状腺癌，不要慌。手术只是抗癌治疗的<span style="color: black;">第1</span>步，之后<span style="color: black;">必须</span><span style="color: black;">定时</span><span style="color: black;">检测</span>，<span style="color: black;">包含</span>甲功、甲状腺球蛋白、甲状腺球蛋白抗体、TSH值等指标，以便于及早<span style="color: black;">发掘</span>复发苗头，及早采取<span style="color: black;">办法</span>。<a style="color: black;"><span style="color: black;">返回<span style="color: black;">外链论坛：http://www.fok120.com/</span>，查看<span style="color: black;">更加多</span></span></a></p>
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