难治性甲状腺癌靶向治疗的分子基础及治疗进展

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1、授予单位代码10089学号或申请号20153268中国图书分类号R605HebeiMedicalUniversity硕士学位论文专业学位难治性甲状腺癌靶向治疗的分子基础及治疗进展研究生：张文涛导师：李清怀教授专业：外科学二级学院：河北医科大学第二医院2018年3月目录中文摘要············································································································1英文摘要·············································

2、·······························································2英文缩写············································································································3综述难治性甲状腺癌靶向治疗的分子基础及治疗进展····························4致谢·································································

3、·················································25个人简历··········································································································26中文摘要难治性甲状腺癌靶向治疗的分子基础及治疗进展摘要甲状腺癌无疑成为最常见的头颈部恶性肿瘤，其中分化型甲状腺癌（DTC）约占90%（甲状腺乳头状癌PTC及滤泡状癌FTC），以手术为主要治疗手段，术后根据病情，予以TSH抑制治疗以及I-131治疗。DTC的预后较好，

4、其5年生存率在90%以上。其中大约有20%的患者会复发，10%的患者会有远处转移。复发的分化型甲状腺癌往往会出现一定程度的去分化现象，失去对碘的摄取能力，因此放射碘疗法对其会不敏感，患者的10年生存率也会降至10%以下。而此时针对分化型甲状腺癌的治疗方案显然就行不通。在充分了解甲状腺癌的遗传和生物学特性的基础上，加上新的分子靶向治疗技术的应用，使得甲状腺癌患者的诊断和治疗得到了改善。现就甲状腺癌（尤其是难治性甲状腺癌）的常见基因变异位点、现有治疗手段及其靶向治疗的最新研究进展做一综述。关键词：甲状腺癌，治疗手段，生存率，基因变异位点，分子靶向治疗1英文摘要Molecularmechan

5、ismandtherapeuticprogressoftargetedtherapyforrefractorythyroidcancerABSTRACTThereisnodoubtthatthyroidcarcinomahasbecomethemostcommonmalignanttumorintheheadandneck.Differentiatedthyroidcarcinoma(DTC)accountsforapproximately90%ofallthyroidcancertypes.Thetreatmentformostthyroidcancersisbasedonsurge

6、ry,Radiationtherapy(forDTCs),andthyroid-stimulationhormone(TSH)suppressiontreatment.The5-yearsurvivalrateisabove90%.However,approximately20%ofthemwillexperiencelocalrecurrenceand10%havedistantmetastasis.TheDTCofrecurrenceoftenpresentslessdifferentiated,losesthecapabilityofiodineuptakesoastoloset

7、heradioiodinetherapy.Atthattime,the10-yeardisease-specificmortalitydropsbelow10%at10years.Thetraditionaltreatmentsfordifferentiatedthyroidcancersareextremelyrestricted.Onthebasisoffullyunderstandingthegeneticandbiologicalcha