《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：分化型甲状腺癌的外科治疗进展

时倩; 房居高

doi:10.19401/j.cnki.1007-3639.2025.10.004

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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：分化型甲状腺癌的外科治疗进展

专家述评 | 更新时间：2025-12-31

- 《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：分化型甲状腺癌的外科治疗进展
- Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: advances in surgical treatment of differentiated thyroid cancer
- 中国癌症杂志 2025年35卷第10期页码：929-934
- 作者机构：
  
  首都医科大学附属北京同仁医院耳鼻咽喉-头颈外科，北京 100730
- 作者简介：
  
  [ "时倩（0009-0001-1666-3728），副主任医师。" ]
  [ "房居高，一级主任医师，教授，首都医科大学附属北京同仁医院耳鼻咽喉-头颈外科主任，为享受国务院政府特殊津贴专家。现任中国抗癌协会头颈肿瘤专业委员会主任委员，中国抗癌协会甲状腺癌专业委员会常务委员，中国预防医学会甲状腺疾病防治分会副主任委员，中国医疗保健国际交流促进会甲状腺疾病学分会顾问、首任主任委员，国家自然科学基金评审专家，国家科学技术奖励工作办公室评审专家。长期致力于甲状腺癌及头颈鳞癌的治疗、临床研究及基础研究。发表论文200余篇，其中在SCI收录期刊上发表论文100余篇；主编、副主编、主译、副主译专著16部；获省部级科技进步奖两项。" ]
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2025.10.004
  中图分类号： R736.1
- 收稿：2025-09-26，
  
  修回：2025-10-24，
  
  纸质出版：2025-10-30
- 稿件说明：
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时倩, 房居高. 《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：分化型甲状腺癌的外科治疗进展[J]. 中国癌症杂志, 2025,35(10):929-934.

Qian SHI, Jugao FANG. Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: advances in surgical treatment of differentiated thyroid cancer[J]. China Oncology, 2025, 35(10): 929-934.
时倩, 房居高. 《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读：分化型甲状腺癌的外科治疗进展[J]. 中国癌症杂志, 2025,35(10):929-934. DOI： 10.19401/j.cnki.1007-3639.2025.10.004.

Qian SHI, Jugao FANG. Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer: advances in surgical treatment of differentiated thyroid cancer[J]. China Oncology, 2025, 35(10): 929-934. DOI： 10.19401/j.cnki.1007-3639.2025.10.004.

摘要

《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》（简称2025年版ATA指南）对于分化型甲状腺癌（differentiated thyroid cancer，DTC）的外科治疗总体的趋势是，低危组的患者手术范围更加趋于保守，中危组病例倾向采用个体化治疗；强调根据患者的病变范围、临床分期和肿瘤的特性、患者的偏好来选择治疗方案。在确定初步治疗目标时，与患者共同决策至关重要。对于Ⅵ区淋巴结的预防性清扫，也偏向保守。在推荐治疗方案时，必须酌情考虑患者的偏好。对于选择手术治疗的患者，首要目标是切除原发肿瘤以及转移淋巴结，手术切除的彻底性是决定患者预后的重要因素。手术治疗的主要目标是：① 降低疾病持续/复发和转移扩散的风险。② 最大限度地减少治疗相关并发症。一定要权衡手术的获益和风险，这些风险如永久性甲状旁腺功能低下所带来的负担和对患者的伤害可能超过甲状腺癌疾病本身。本文对2025年版ATA指南在外科治疗领域的内容更新和进展要点予以梳理，以期为甲状腺癌外科医师提供参考。

Abstract

Regarding the surgical treatment of differentiated thyroid cancer (DTC) in the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer (abbreviation ATA guideline)

the overall trend is that for patients in the low-risk group

the surgical scope tends to be more conservative

while for cases in the intermediate-risk group

more individualized treatment is adopted. It emphasizes that the treatment plan should be selected based on the extent of disease

clinical stage

tumor characteristics

and patient preferences. When determining initial treatment goals

shared decision-making with the patient is crucial. When recommending treatment plans

patient preferences must be taken into account as appropriate. For patients who choose surgical treatment

the primary goal is to resect the primary tumor and metastatic lymph nodes. The completeness of surgical resection is an important factor determining prognosis. The main goals should be: reducing the risk of persistent/recurrent disease and metastatic spread

and minimizing treatment-related complications. It is essential to weigh the benefits and risks of surgery; for instance

the burden and harm to the patient caused by permanent hypoparathyroidism may outweigh the thyroid cancer itself. This article summarizes the important progress of the 2025 ATA guidelines in the field of surgery

in order to provide reference for thyroid cancer physicians.

关键词

Keywords

references

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