这几种类型的甲状腺癌,你分的清楚吗?
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺癌是最<span style="color: black;">平常</span>的甲状腺恶性肿瘤,近年来发病率呈<span style="color: black;">提升</span>趋势;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有人说甲状腺癌是幸福癌,预后较好,死亡率较低;</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-1d03a00373f4477602e8c93ca009aa73_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;">而又有人<span style="color: black;">叫作</span>甲状腺癌很可怕,预后极差,发展<span style="color: black;">快速</span>,死亡率很高;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">难道是有人在说谎吗?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">事实<span style="color: black;">便是</span>两者说的均有可能,<span style="color: black;">由于</span>这<span style="color: black;">重点</span>取决于你患上了哪种类型的甲状腺癌。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">接下来就揭开这几种甲状腺癌的面纱吧。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">1、</span>乳头状癌:</h2>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic2.zhimg.com/80/v2-5b179a0c9e5d45a5e2b3392b6b5ace55_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;">乳腺状癌约占成人甲状腺癌的60%和儿童甲状腺癌的<span style="color: black;">所有</span>;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型多见于30-45岁女性;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型分化较好,生长缓慢,恶性程度低;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">该病常有多中心病灶,约1/3累及双侧甲状腺,且较早就会<span style="color: black;">显现</span>颈淋巴结转移,但预后较好;</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">2、</span>滤泡状癌:</h2>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-18fb7ffbd364e086a8514251d30ce626_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;">滤泡状癌约占甲状腺癌的20%;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型多见于50岁<span style="color: black;">上下</span>的中年人;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型肿瘤生长较快,属于中度恶性,且有侵犯血管倾向,可经血运转移到肺、肝和骨及中枢系统;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型颈淋巴结转移仅占10%,<span style="color: black;">因此呢</span>病人预后不如乳头状癌;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺癌和滤泡状癌统<span style="color: black;">叫作</span>为分化型甲状腺癌,治疗以手术治疗为主,但甲状腺的切除范围<span style="color: black;">日前</span>还有<span style="color: black;">歧义</span>,最小范围为腺叶切除;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">意见</span>甲状腺全切或近全切的指征有:①颈部有放射史,②已有远处转移,③双侧癌结节,④甲状腺外侵犯,⑤肿块直径>4cm,⑥不良病理类型:高细胞型、柱状细胞型、弥漫硬化性岛状细胞或分化程度低的变型,⑦双侧颈部多发淋巴结转移;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">意见</span>仅腺叶切除的指征有:①<span style="color: black;">没</span>颈部放射史,②<span style="color: black;">没</span>远处转移,③<span style="color: black;">没</span>甲状腺外侵犯,④<span style="color: black;">没</span>其他不良病理类型,⑤肿块直径<1cm;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">良性病变行腺叶切除术后病理证实为分化型甲状腺癌者,若切缘阴性、对侧正常、肿块直径<1cm,可观察,否则须再行手术;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺癌作次全切或全切除者,应终身<span style="color: black;">吃下</span>甲状腺素片或左甲状腺素,以预防甲状腺功能<span style="color: black;">衰退</span>及<span style="color: black;">控制</span>甲状腺激素,避免肿瘤复发。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">3、</span>未分化癌:</h2>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-19d6b6fc7c03d82a15e92a5761d1ce68_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;">未分化癌约占甲状腺癌的15%;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型多见于70岁<span style="color: black;">上下</span>老年人;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型发展<span style="color: black;">快速</span>,高度恶性,且约50%<span style="color: black;">初期</span>便有颈淋巴结转移,或侵犯气管、喉返神经或食管,常经血运向肺、骨等远处转移;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">故本型预后很差,平均存活3-6个月<span style="color: black;">上下</span>,一年存活率仅5%-15%;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">未分化癌不主张手术治疗,<span style="color: black;">重点</span>采取放射外照射治疗。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">4、</span>髓样癌:</h2>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-6ffc5658fc4e18de51688be2f0b71756_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;">髓样癌仅占甲状腺癌的7%;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">髓样癌<span style="color: black;">重点</span><span style="color: black;">源自</span>于滤泡旁降钙素分泌细胞(C细胞),细胞<span style="color: black;">摆列</span>呈巢状或囊状,<span style="color: black;">没</span>乳头或滤泡结构,呈未分化状,间质内有淀粉样物沉积;</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本型恶性程度中等,可有颈淋巴结侵犯和血行转移,预后不如乳头状癌,但较未分化癌好。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术是治疗髓样癌最有效的手段,多主张甲状腺全切或近全切。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以上<span style="color: black;">便是</span>不同类型甲状腺癌的基本内容了,<span style="color: black;">期盼</span>对你有所<span style="color: black;">帮忙</span>。</p>
感谢你的精彩评论,带给我新的思考角度。
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