甲状腺癌的复发率到底有多高？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺癌手术结束后</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>人<span style="color: black;">尤其</span>关心自己复发的概率</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲癌术后复发并不少见</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">亦</span>是一个很容易<span style="color: black;">导致</span>焦虑的<span style="color: black;">专题</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">咱们</span>就从大数据出发</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">聊聊甲癌术后的复发率</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">术后复发率</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2015版美国甲状腺协会的指南</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">给出了术后复发<span style="color: black;">危害</span>的<span style="color: black;">评定</span><span style="color: black;">办法</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>病理报告的<span style="color: black;">详细</span>内容</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">估算术后5-10年的复发<span style="color: black;">危害</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">根据</span><span style="color: black;">危害</span>高低将分化型甲癌分为高，中和低危</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">1 低危（<10%）</h3>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-d614d3511f2242f108ee38e1a5ec1c5f_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">乳头状癌复发<span style="color: black;">危害</span>和<span style="color: black;">体积</span>关系不大</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">单发微小癌复发率仅为1-2%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发微小癌<span style="color: black;">增多</span>到4-6%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">直径2-4厘米时复发率约为5%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">直径超过4厘米复发率是8-10%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">即便<span style="color: black;">显现</span>了轻微的转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复发<span style="color: black;">危害</span><span style="color: black;">亦</span>只是略有<span style="color: black;">加强</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">少量隐匿转移的复发率是2-5%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">微小腺外侵犯的复发率是3-8%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">没</span>论多大的分化型甲癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">只要<span style="color: black;">无</span><span style="color: black;">显现</span>临床可见的转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">无</span><span style="color: black;">尤其</span><span style="color: black;">欠好</span>的病理特征</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复发<span style="color: black;">危害</span><span style="color: black;">一般</span>不超过10%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">此时</span>将其定义为低危</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">2 中危（10-30%）</h3>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-1840e91a01a659fe8632f9d2e1a2c390_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当病理报告<span style="color: black;">显现</span>临床可见的淋巴结转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">或</span>隐匿转移数目超过5枚</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复发<span style="color: black;">危害</span>约为20%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>肿瘤属于侵蚀性亚型</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">或</span>显微镜下<span style="color: black;">显现</span>血管侵犯</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复发<span style="color: black;">危害</span>则为15-30%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这些都属于中危的分化型甲癌</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">3 高危（>30%）</h3>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-08a878fd5b5bddbebccd087199466146_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当病理报告<span style="color: black;">显现</span><span style="color: black;">有些</span><span style="color: black;">尤其</span>危险的<span style="color: black;">原因</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>腺外侵犯<span style="color: black;">重要</span>结构</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>大面积的淋巴结转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这些属于高复发<span style="color: black;">危害</span>的甲癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复发概率超过了30%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有时术前<span style="color: black;">已然</span>获知远处转移</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">或</span>术中<span style="color: black;">没</span>法完整切除肿瘤</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">再<span style="color: black;">或</span>术后的Tg非常高</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这些<span style="color: black;">状况</span>术后复发概率其实是100%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">由于</span><span style="color: black;">身体</span>还存在<span style="color: black;">知道</span>的病灶</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">半切对比全切</h2>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-0e64cc04382ac60e484cf14de0464786_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">抛开病情本身的严重程度</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术方式<span style="color: black;">是不是</span>影响复发率呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">半切<span style="color: black;">一般</span>适用于低危和中危中较轻的<span style="color: black;">状况</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">日前</span>的统计结果<span style="color: black;">表示</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">病情相同的<span style="color: black;">状况</span>下</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">半切的总复发率是略高于全切的</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-b4fc893e5bacd47823eeb13273f0a638_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这个结果很好解释</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复发可能<span style="color: black;">出现</span>在甲状腺，甲状腺床，淋巴结和远处</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中低危在甲状腺床和远处的复发非常罕见</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">相比于半切</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">全切虽<span style="color: black;">不可</span>减少在淋巴结中复发的几率</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但能消除在剩余甲状腺中复发的几率</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">累积复发率</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">上面数字是基于术后5-10年的统计</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲癌的复发<span style="color: black;">危害</span>是终身存在的</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span><span style="color: black;">第1</span>个十年的复发<span style="color: black;">危害</span>是10%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">到第二个十年可能降到1-5%</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">随着时间的推移<span style="color: black;">危害</span>会越来越低</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但并不会归零</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">由于</span>甲癌是<span style="color: black;">发展</span>非常缓慢的肿瘤</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">复发的<span style="color: black;">关联</span>认知</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>人就有疑问</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这么统计下来甲癌的复发率并不低</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">为何</span><span style="color: black;">大众</span>还说甲癌不可怕？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大众</span>要理解复发率<span style="color: black;">便是</span>个数字<span style="color: black;">罢了</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">比数字更<span style="color: black;">要紧</span>的是</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>有一天不幸复发了</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">会不会对<span style="color: black;">将来</span>的生活有很大影响？</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>人过度焦虑甲癌复发</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">恰恰是对甲癌复发<span style="color: black;">无</span>正确的认知</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">绝大<span style="color: black;">都数</span>甲癌的复发并不是一件“大事”</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">相反很容易处理和<span style="color: black;">处理</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">咱们</span>下期<span style="color: black;">能够</span>接着聊</p>最后，欢迎关注最专业的甲状腺公众号「温哥华小文青」。
你的见解真是独到，让我受益匪浅。 感谢楼主分享，祝愿外链论坛越办越好！
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