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《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：围手术期甲状旁腺功能的评估、处理及术后TSH抑制的精准个体化管理
Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: perioperative assessment and management of parathyroid function and precision individualized management of postoperative TSH suppression in adults with differentiated thyroid cancer
- 中国癌症杂志 2025年35卷第9期 页码：841-849
- 作者机构：
1. 北京大学第一医院内分泌科，北京 100034
2. 浙江省人民医院内分泌科，浙江 杭州 310014
- 作者简介：
[ "伍一鸣（ORCID: 0009-0001-9414-1159），硕士，副主任医师；" ]
[ "冯楚瑶（ORCID: 0000-0003-1487-9119），博士，住院医师。" ]
[ "高莹，主任医师、教授、博士研究生导师、博士后合作导师，北京大学第一医院内分泌科主任、药物临床试验中心主任。中华医学会内分泌学分会甲状腺学组及免疫内分泌学组委员，中华医学会糖尿病分会血糖监测与新技术委员，中国老年医学学会内分泌代谢分会常委，北京医学会内分泌学分会委员。研究方向为自身免疫性甲状腺疾病的内分泌治疗。先后承担国家级、省部级课题14项，在SCI收录期刊上发表论文60余篇，其中以第一作者和通讯作者发表40余篇。参与《中国甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南》《中国老年2型糖尿病防治临床指南》《中国老年人甲状腺疾病诊疗专家共识》等多部指南与共识的撰写工作。曾获“华夏内分泌大会青年研究者奖”、中华医学科技奖三等奖及教育部一等奖，并入选北京市“科技新星”及教育部“新世纪优秀人才支持计划”。" ]
[ "武晓泓，主任医师、教授、博士研究生导师，浙江省人民医院内分泌科主任、浙江省糖尿病防治中心副主任。浙江省万人计划科技创新领军人才、卫生创新人才，中华预防医学会甲状腺疾病防治专业委员会常务委员，中国临床肿瘤学会甲状腺癌专家委员会副主任委员，中国微循环学会糖尿病与微循环专业委员会常委兼秘书长，中国医师协会内分泌代谢科医师分会委员，浙江省预防医学会糖尿病预防与控制专业委员会主任委员，浙江省医学会内分泌学分会副主任委员，浙江省医师协会内分泌代谢科医师分会副会长。研究方向为糖尿病泛血管病变防治、甲状腺结节恶性风险评估及个体化诊疗。主持国家自然科学基金4项、省部级项目12项。发表论文120篇。获得省市级科研奖励5次，荣获市五一劳动奖章。" ]
- 基金信息：
DOI：10.19401/j.cnki.1007-3639.2025.09.004
中图分类号： R736.1收稿：2025-09-10，
修回：2025-09-23，
纸质出版：2025-09-30
- 稿件说明：
移动端阅览
伍一鸣, 冯楚瑶, 高莹, 等. 《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：围手术期甲状旁腺功能的评估、处理及术后TSH抑制的精准个体化管理[J]. 中国癌症杂志, 2025,35(9):841-849.
Yiming WU, Chuyao FENG, Ying GAO, et al. Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: perioperative assessment and management of parathyroid function and precision individualized management of postoperative TSH suppression in adults with differentiated thyroid cancer[J]. China Oncology, 2025, 35(9): 841-849.
伍一鸣, 冯楚瑶, 高莹, 等. 《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：围手术期甲状旁腺功能的评估、处理及术后TSH抑制的精准个体化管理[J]. 中国癌症杂志, 2025,35(9):841-849. DOI： 10.19401/j.cnki.1007-3639.2025.09.004.
Yiming WU, Chuyao FENG, Ying GAO, et al. Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: perioperative assessment and management of parathyroid function and precision individualized management of postoperative TSH suppression in adults with differentiated thyroid cancer[J]. China Oncology, 2025, 35(9): 841-849. DOI： 10.19401/j.cnki.1007-3639.2025.09.004.
摘要
近年来，分化型甲状腺癌（differentiated thyroid cancer，DTC）的发病率持续上升，其围手术期管理和术后促甲状腺激素（thyroid-stimulating hormone，TSH）抑制治疗策略备受关注。2025年美国甲状腺学会（American Thyroid Association，ATA）发布了《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》，在围手术期甲状旁腺功能保护和TSH抑制治疗方面有重要更新。2025版ATA指南推荐术中应用新方法识别并保护甲状旁腺，甲状腺全切术后采用基于甲状旁腺激素（parathyroid hormone，PTH）指导的钙剂和维生素D补充方案。TSH抑制治疗方面，2025版ATA指南取消初治期具体TSH目标值推荐，强调应根据患者初始复发风险和治疗反应动态调整TSH目标，实现个体化管理，避免过度治疗。
Abstract
In recent years
the incidence of differentiated thyroid cancer (DTC) continues to rise
with increasing attention to perioperative management and postoperative thyroid-stimulating hormone (TSH) suppression therapy strategies. The American Thyroid Association (ATA) released the “2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer” in 2025
which include significant updates on perioperative parathyroid function protection and TSH suppression therapy. In terms of perioperative management
the 2025 ATA guidelines recommend intraoperative application of novel methods to identify and protect the parathyroid glands
and adoption of parathyroid hormone (PTH)-guided calcium and vitamin D supplementation protocols following total thyroidectomy. Regarding TSH suppression therapy
the 2025 ATA guidelines eliminate specific TSH target value recommendations for initial treatment
emphasizing that TSH targets should be dynamically adjusted based on patients’ initial recurrence risk and treatment response to achieve individualized management and avoid overtreatment.
关键词
Keywords
references
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