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Коморбідний ендокринологічний пацієнт

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Коморбідний ендокринологічний пацієнт

Міжнародний ендокринологічний журнал 8 (64) 2014

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The modern statements for diagnostics and treatment of medullary thyroid carcinoma

Автори: Kvachenyuk A., Reizin D.

Рубрики: Ендокринологія

Розділи: Довідник фахівця

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The thesis is devoted to the investigation of clinical and epidemiological aspects, gender and age characteristics of tumor growth thyroid medullary carcinoma, the elucidation of the importance of such factors as the tumor metastasis and its size to the choice of tactics and volume of surgery.

A retrospective analysis of a cohorts of patients with medullary carcinoma showed that the structure is dominated by women, its fraction with sporadic medullary carcinoma with age becomes significantly smaller. Among males more than females occurs metastatic tumors in regional lymph nodes and severe form of the disease, higher mortality and the survival rate of male patients compared with women.

Except for frequent tumor metastasis to regional lymph nodes and other specified laws not traceable to hereditary forms of medullary thyroid carcinoma. Furthermore, we show that tumor size more than 2 cm (even in the absence of proven metastasis) is an unfavorable factor that increases mortality among patients, decreases their survival, especially in sporadic tumors.

In the study the results of different nature and volume of surgery on thyroid gland and lymph collectors were found to be important for the choice of treatment strategy is the presence of metastatic tumor and its size. Given the tumor (without metastases) size is not more than 2 cm (T1-2N0M0), a sufficient amount of surgery is total thyroidectomy with central lymph node dissection. If tumors (without metastases) larger than 2 cm (T3-4N0M0) treatment protocol should include total thyroidectomy with central and lateral lymph node dissection.

It is shown that the level of calcitonin in the blood of patients with medullary carcinoma is a necessary component of the protocol preoperative examination of patients in order to diagnose possible tumor micrometastases that are not detected topical methods of diagnosis and postoperative management protocol of patients to detect disease recurrence.



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