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<!DOCTYPE html>
<html lang="zh-CN">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.5, user-scalable=yes" />
<title>甲状腺癌 AJCC8 分期与随访用药参考工具 · Bilingual</title>
<style>
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</style>
</head>
<body>
<div class="card" id="app">
<div class="topbar">
<div><h1 id="title"></h1><span class="badge" id="versionBadge"></span></div>
<div class="actions no-print">
<button class="btn" id="langBtn" type="button"></button>
<button class="btn" id="explainBtn" type="button"></button>
<button class="btn" id="printBtn" type="button"></button>
<button class="btn" id="copyBtn" type="button"></button>
<button class="btn primary" id="resetBtn" type="button"></button>
</div>
</div>
<div class="subhead" id="subhead"></div>
<div class="print-only" id="printMeta"></div>
<div class="grid-panel no-print">
<div class="select-group"><label id="histologyLabel" for="histology"></label><select id="histology"></select></div>
<div class="select-group"><label id="ageLabel" for="ageGroup"></label><select id="ageGroup"></select></div>
<div class="select-group"><label id="tLabel" for="tStage"></label><select id="tStage"></select></div>
<div class="select-group"><label id="nLabel" for="nStage"></label><select id="nStage"></select></div>
<div class="select-group"><label id="mLabel" for="mStage"></label><select id="mStage"></select></div>
<div class="select-group"><label id="surgeryLabel" for="surgeryPlan"></label><select id="surgeryPlan"></select></div>
</div>
<div class="stage-result" id="stageResult">
<div><span class="stage-badge" id="stageBadge"></span><div class="stage-value" id="stageDisplay"></div><div class="stage-desc" id="stageDesc"></div><div class="pill-row"><span class="pill" id="tnmSummary"></span><span class="pill" id="riskSummary"></span></div></div>
<div class="summary-box"><h3 id="interpretTitle"></h3><ul id="interpretList"></ul><div class="small-note explain" id="stageExplain"></div></div>
</div>
<div class="section">
<div class="section-header" data-target="clinicalContent"><h2 id="clinicalHeader"></h2><span class="collapse-icon">▼</span></div>
<div class="section-content open" id="clinicalContent"><div class="section-body" id="managementPanel"></div></div>
</div>
<div class="section">
<div class="section-header" data-target="rulesContent"><h2 id="rulesHeader"></h2><span class="collapse-icon">▼</span></div>
<div class="section-content" id="rulesContent"><div class="section-body" id="rulesPanel"></div></div>
</div>
<div class="refs" id="referencesBox"></div>
<div class="footnote" id="footnote"></div>
</div>
<script>
(function(){
let lang='zh';
let explainVisible=false;
const $=id=>document.getElementById(id);
const optionData={
histology:[{v:'DTC',zh:'分化型癌（DTC）· 乳头状/滤泡状',en:'Differentiated thyroid cancer (DTC) · Papillary/Follicular'},{v:'MTC',zh:'甲状腺髓样癌（MTC）',en:'Medullary thyroid cancer (MTC)'},{v:'ATC',zh:'未分化癌（ATC）',en:'Anaplastic thyroid cancer (ATC)'}],
ageGroup:[{v:'<55',zh:'＜55 岁',en:'<55 years'},{v:'≥55',zh:'≥55 岁',en:'≥55 years'}],
tStage:[{v:'T1a',zh:'T1a（≤1 cm，局限于甲状腺内）',en:'T1a (≤1 cm, intrathyroidal)'},{v:'T1b',zh:'T1b（＞1–2 cm，局限于甲状腺内）',en:'T1b (>1–2 cm, intrathyroidal)'},{v:'T2',zh:'T2（＞2–4 cm，局限于甲状腺内）',en:'T2 (>2–4 cm, intrathyroidal)'},{v:'T3a',zh:'T3a（＞4 cm，局限于甲状腺内）',en:'T3a (>4 cm, intrathyroidal)'},{v:'T3b',zh:'T3b（任何大小，侵犯带状肌）',en:'T3b (gross strap muscle invasion)'},{v:'T4a',zh:'T4a（侵犯皮下/喉/气管/食管/喉返神经）',en:'T4a (invades subcutaneous tissue/larynx/trachea/esophagus/RLN)'},{v:'T4b',zh:'T4b（侵犯椎前筋膜/包绕颈动脉/纵隔血管）',en:'T4b (prevertebral fascia/carotid encasement/mediastinal vessels)'}],
nStage:[{v:'N0',zh:'N0（无区域淋巴结转移）',en:'N0 (no regional nodal metastasis)'},{v:'N1a',zh:'N1a（Ⅵ区/Ⅶ区淋巴结转移）',en:'N1a (level VI/VII nodes)'},{v:'N1b',zh:'N1b（侧颈部/咽后淋巴结转移）',en:'N1b (lateral neck/retropharyngeal nodes)'}],
mStage:[{v:'M0',zh:'M0（无远处转移）',en:'M0 (no distant metastasis)'},{v:'M1',zh:'M1（有远处转移）',en:'M1 (distant metastasis)'}],
surgeryPlan:[{v:'notSelected',zh:'未选择/待 MDT 确认',en:'Not selected / pending MDT confirmation'},{v:'activeSurveillance',zh:'主动监测：cT1a ≤1 cm、cN0、M0、低危',en:'Active surveillance: cT1a ≤1 cm, cN0, M0, low-risk'},{v:'lobectomy',zh:'腺叶切除±峡部：≤4 cm、局限、cN0 低危 DTC',en:'Lobectomy ± isthmusectomy: ≤4 cm, confined, cN0 low-risk DTC'},{v:'totalThyroidectomy',zh:'全/近全甲状腺切除：>4 cm、T3/T4、N1、M1 或高危',en:'Total/near-total thyroidectomy: >4 cm, T3/T4, N1, M1, or high-risk'},{v:'centralDissection',zh:'中央区清扫：临床 N1a 或治疗性清扫',en:'Central neck dissection: clinical N1a or therapeutic dissection'},{v:'lateralDissection',zh:'侧颈清扫：临床 N1b',en:'Lateral neck dissection: clinical N1b'},{v:'invasiveResection',zh:'侵犯结构切除/气道评估：T4a/T4b',en:'Resection of invaded structures / airway assessment: T4a/T4b'},{v:'unresectablePalliative',zh:'不可切除/姑息/系统治疗路径',en:'Unresectable / palliative / systemic-therapy pathway'}]
};
const labels={
zh:{title:'甲状腺癌 AJCC8 分期与随访用药参考工具',version:'AJCC第8版 · 随访/用药数值版 · 中英双语',subhead:'正文表格只显示目标值、检查项目和时间点；解释说明默认隐藏，可单独显示。治疗方案需由临床团队确认。',langBtn:'🌐 English',explainShow:'👁️ 显示解释',explainHide:'🙈 隐藏解释',printBtn:'🖨️ 打印报告',copyBtn:'📄 复制摘要',resetBtn:'↻ 重置',histologyLabel:'🧬 病理类型',ageLabel:'🎂 诊断年龄（仅DTC）',tLabel:'📏 原发肿瘤（T）',nLabel:'🔬 区域淋巴结（N）',mLabel:'🌍 远处转移（M）',surgeryLabel:'🔪 手术方式/路径',stageBadge:'🎯 当前分期',interpretTitle:'当前结果',clinicalHeader:'📋 随访、用药、手术路径',rulesHeader:'📌 AJCC8 分期规则与限制',tnm:'TNM',risk:'参考层级',surgery:'手术路径',chosenSurgery:'已选路径',printMeta:'打印时间',riskLevels:{low:'低危参考',intermediate:'中危参考',high:'高危参考',advanced:'晚期/转移性参考'},footnote:'仅供专业参考；不替代医生判断、MDT、当地药品说明书或最新指南。',sourceTitle:'参考依据与适用范围',sourceNote:'DTC 随访/TSH 内容优先参考 2025 ATA DTC 更新；MTC 参考 ATA MTC 指南工具；ATC 参考 ATA ATC 指南工具和 NCCN 2025 甲状腺癌更新摘要。'},
en:{title:'Thyroid Cancer AJCC8 Staging, Follow-up and Medication Reference Tool',version:'AJCC 8th · Numeric follow-up/medication version · Bilingual',subhead:'Main tables show targets, tests, and time intervals only; explanatory notes are hidden by default and can be toggled separately. Clinical confirmation is required.',langBtn:'🌐 中文',explainShow:'👁️ Show explanations',explainHide:'🙈 Hide explanations',printBtn:'🖨️ Print report',copyBtn:'📄 Copy summary',resetBtn:'↻ Reset',histologyLabel:'🧬 Histology',ageLabel:'🎂 Age at diagnosis (DTC only)',tLabel:'📏 Primary tumor (T)',nLabel:'🔬 Regional nodes (N)',mLabel:'🌍 Distant metastasis (M)',surgeryLabel:'🔪 Surgery / pathway',stageBadge:'🎯 Current stage',interpretTitle:'Current result',clinicalHeader:'📋 Follow-up, medication, and surgery pathway',rulesHeader:'📌 AJCC8 staging rules and limits',tnm:'TNM',risk:'Reference tier',surgery:'Surgery pathway',chosenSurgery:'Selected pathway',printMeta:'Printed at',riskLevels:{low:'Low-risk reference',intermediate:'Intermediate-risk reference',high:'High-risk reference',advanced:'Advanced/metastatic reference'},footnote:'Professional reference only; does not replace clinician judgment, MDT review, local drug labels, or current guidelines.',sourceTitle:'Sources and scope',sourceNote:'DTC follow-up/TSH content prioritizes the 2025 ATA DTC update; MTC references ATA MTC guideline tools; ATC references ATA ATC guideline tools and NCCN 2025 thyroid carcinoma update summary.'}
};
const refs={
zh:[['美国癌症协会：AJCC8 甲状腺癌分期','https://www.cancer.org/cancer/types/thyroid-cancer/detection-diagnosis-staging/staging.html'],['2025 ATA 成人分化型甲状腺癌指南','https://journals.sagepub.com/doi/pdf/10.1177/10507256251363120'],['ATA 2025 DTC 快速参考工具','https://eguideline.guidelinecentral.com/ata-guidelines-tools/adults-with-differentiated-thyroid-cancer-2025-update'],['ATA MTC 指南工具','https://eguideline.guidelinecentral.com/i/540772-medullary-thyroid-carcinoma'],['ATA ATC 指南工具','https://www.guidelinecentral.com/guideline/7119/'],['NCCN 2025 甲状腺癌更新摘要','https://jnccn.org/view/journals/jnccn/23/7/article-e250033.xml']],
en:[['American Cancer Society: AJCC8 thyroid cancer staging','https://www.cancer.org/cancer/types/thyroid-cancer/detection-diagnosis-staging/staging.html'],['2025 ATA adult DTC guideline','https://journals.sagepub.com/doi/pdf/10.1177/10507256251363120'],['ATA 2025 DTC quick-reference tool','https://eguideline.guidelinecentral.com/ata-guidelines-tools/adults-with-differentiated-thyroid-cancer-2025-update'],['ATA MTC guideline tool','https://eguideline.guidelinecentral.com/i/540772-medullary-thyroid-carcinoma'],['ATA ATC guideline tool','https://www.guidelinecentral.com/guideline/7119/'],['NCCN 2025 thyroid carcinoma update summary','https://jnccn.org/view/journals/jnccn/23/7/article-e250033.xml']]
};
function parseT(t){if(t==='T1a')return{main:'T1',sub:'a',cm:'≤1 cm'}; if(t==='T1b')return{main:'T1',sub:'b',cm:'>1–2 cm'}; if(t==='T2')return{main:'T2',sub:'',cm:'>2–4 cm'}; if(t==='T3a')return{main:'T3',sub:'a',cm:'>4 cm'}; if(t==='T3b')return{main:'T3',sub:'b',cm:'strap muscle invasion'}; if(t==='T4a')return{main:'T4',sub:'a',cm:'T4a'}; return{main:'T4',sub:'b',cm:'T4b'};}
function computeStage(){const hist=$('histology').value,age=$('ageGroup').value,tVal=$('tStage').value,nVal=$('nStage').value,mVal=$('mStage').value,t=parseT(tVal),isM1=mVal==='M1';let stage='',desc='';
if(hist==='DTC'){if(age==='<55'){stage=isM1?'Ⅱ 期':'Ⅰ 期';desc=isM1?'M1':'M0';}else{const anyN1=nVal==='N1a'||nVal==='N1b'; if(isM1){stage='ⅣB 期';desc='M1';}else if(t.main==='T4'&&t.sub==='b'){stage='ⅣA 期';desc='T4b any N M0';}else if(t.main==='T4'&&t.sub==='a'){stage='Ⅲ 期';desc='T4a any N M0';}else if(t.main==='T3'){stage='Ⅱ 期';desc=`${tVal} any N M0`;}else if((t.main==='T1'||t.main==='T2')&&anyN1){stage='Ⅱ 期';desc=`${tVal} N1 M0`;}else{stage='Ⅰ 期';desc=`${tVal} N0 M0`;}}}
else if(hist==='MTC'){if(isM1){stage='ⅣC 期';desc='M1';}else if(t.main==='T4'&&t.sub==='b'){stage='ⅣB 期';desc='T4b any N M0';}else if(t.main==='T4'&&t.sub==='a'){stage='ⅣA 期';desc='T4a any N M0';}else if(nVal==='N1b'){stage='ⅣA 期';desc='N1b M0';}else if(nVal==='N1a'){stage='Ⅲ 期';desc='N1a M0';}else if(t.main==='T2'||t.main==='T3'){stage='Ⅱ 期';desc=`${tVal} N0 M0`;}else{stage='Ⅰ 期';desc='T1 N0 M0';}}
else{if(isM1){stage='ⅣC 期';desc='M1';}else if((t.main==='T3'&&t.sub==='b')||t.main==='T4'||nVal!=='N0'){stage='ⅣB 期';desc='T3b/T4 or N1 M0';}else{stage='ⅣA 期';desc='T1–T3a N0 M0';}}
return{stage,desc,tnm:`${tVal} ${nVal} ${mVal}`};}
function computeRisk(s){const hist=$('histology').value,t=parseT($('tStage').value),n=$('nStage').value,m=$('mStage').value;if(hist==='ATC')return'advanced'; if(m==='M1'||s.stage.includes('Ⅳ'))return'advanced'; if(hist==='MTC'){if(s.stage.includes('Ⅲ'))return'high'; if(s.stage.includes('Ⅱ'))return'intermediate'; return'low';} if(s.stage.includes('Ⅲ')||t.main==='T4')return'high'; if(n!=='N0'||t.main==='T3'||s.stage.includes('Ⅱ'))return'intermediate'; return'low';}
function getText(id){const sel=$(id);return sel.options[sel.selectedIndex].textContent;}
function escapeHtml(s){return String(s).replace(/[&<>"]/g,c=>({'&':'&','<':'<','>':'>','"':'"'}[c]));}
function table(title,headers,rows,note,wide=false){
const esc=escapeHtml;
const head=headers.map(h=>`<th>${esc(h)}</th>`).join('');
const body=rows.map(r=>`<tr>${r.map((c,i)=>{const v=esc(c);return `<td>${i===1?'<span class="main-value">':''}${v}${i===1?'</span>':''}</td>`;}).join('')}</tr>`).join('');
return `<div class="mini-card ${wide?'full':''}"><h3>${esc(title)}</h3><table class="data-table"><thead><tr>${head}</tr></thead><tbody>${body}</tbody></table>${note?`<div class="small-note explain">${esc(note)}</div>`:''}</div>`;
}
function card(title,items,note='',extra=''){
const esc=escapeHtml;
return `<div class="mini-card ${extra}"><h3>${esc(title)}</h3><ul>${items.map(i=>`<li>${esc(i)}</li>`).join('')}</ul>${note?`<div class="small-note explain">${esc(note)}</div>`:''}</div>`;
}
function surgeryRows(){const hist=$('histology').value,t=$('tStage').value,n=$('nStage').value,m=$('mStage').value; if(lang==='zh')return [
['主动监测','cT1a ≤1 cm + cN0 + M0','颈部超声：6个月×前2年；之后12–24个月'],
['腺叶切除±峡部','DTC：≤4 cm + 局限 + cN0','术后病理/Tg/TgAb：6–12周首次'],
['全/近全甲状腺切除','>4 cm 或 T3/T4 或 N1 或 M1','术后TSH/FT4：6–8周；Tg/TgAb：6–12周'],
['中央区清扫','临床N1a；治疗性清扫','术后钙/甲旁腺激素：24–48小时内；按结果复测'],
['侧颈清扫','临床N1b','术后影像/声带/钙代谢：按术后0–12周路径'],
['侵犯结构/不可切除路径','T4a/T4b 或 ATC 或快速进展','气道评估：当天；MDT：≤1周；基因检测：尽快']
]; return [
['Active surveillance','cT1a ≤1 cm + cN0 + M0','Neck US: every 6 months for 2 years; then every 12–24 months'],
['Lobectomy ± isthmusectomy','DTC: ≤4 cm + confined + cN0','Pathology/Tg/TgAb: first check at 6–12 weeks'],
['Total/near-total thyroidectomy','>4 cm or T3/T4 or N1 or M1','TSH/FT4: 6–8 weeks; Tg/TgAb: 6–12 weeks'],
['Central neck dissection','Clinical N1a; therapeutic dissection','Calcium/PTH: within 24–48 hours; repeat per result'],
['Lateral neck dissection','Clinical N1b','Imaging/vocal cord/calcium pathway: postoperative 0–12 weeks'],
['Invasive/unresectable pathway','T4a/T4b or ATC or rapid progression','Airway: same day; MDT: ≤1 week; molecular testing: ASAP']
];}
function dtcMedicationRows(risk){const surgery=$('surgeryPlan').value; const advanced=risk==='advanced'; if(lang==='zh'){
if(advanced)return [['LT4/TSH','<0.1 mU/L；不能耐受时 0.1–0.5 mU/L','TSH/FT4：调剂后6–8周；稳定后3–6个月'],['影像疗效','CT/MRI/PET-CT：8–12周','系统治疗期每8–12周'],['Tg/TgAb','每3–6个月','进展期或治疗调整期']];
if(risk==='high')return [['LT4/TSH','<0.1 mU/L','TSH/FT4：调剂后6–8周；前2年每3–6个月'],['Tg/TgAb','每3–6个月','前2年；稳定后6–12个月'],['颈部超声','6–12个月首次；之后6–12个月','高危或可疑结果']];
if(risk==='intermediate')return [['LT4/TSH','0.1–0.5 mU/L','TSH/FT4：调剂后6–8周；稳定后6–12个月'],['Tg/TgAb','每6–12个月','前2年；可疑时缩短至3–6个月'],['颈部超声','术后6–12个月首次；之后12–24个月','按Tg/TgAb和影像结果']];
return [['LT4/TSH','0.5–2.0 mU/L','TSH/FT4：调剂后6–8周；稳定后6–12个月'],['Tg/TgAb','每6–12个月；疗效满意后12–24个月','全切±RAI路径'],['颈部超声','术后6–12个月首次；之后12–24个月','低危/阴性结果路径']];}
if(advanced)return [['LT4/TSH','<0.1 mU/L; 0.1–0.5 mU/L if not tolerated','TSH/FT4: 6–8 weeks after dose change; then every 3–6 months'],['Response imaging','CT/MRI/PET-CT: 8–12 weeks','Every 8–12 weeks during systemic therapy'],['Tg/TgAb','Every 3–6 months','Progressive disease or treatment-adjustment period']];
if(risk==='high')return [['LT4/TSH','<0.1 mU/L','TSH/FT4: 6–8 weeks after dose change; every 3–6 months for 2 years'],['Tg/TgAb','Every 3–6 months','First 2 years; then every 6–12 months if stable'],['Neck ultrasound','First at 6–12 months; then every 6–12 months','High-risk or suspicious-result pathway']];
if(risk==='intermediate')return [['LT4/TSH','0.1–0.5 mU/L','TSH/FT4: 6–8 weeks after dose change; then every 6–12 months'],['Tg/TgAb','Every 6–12 months','First 2 years; shorten to 3–6 months if suspicious'],['Neck ultrasound','First at 6–12 months; then every 12–24 months','According to Tg/TgAb and imaging']];
return [['LT4/TSH','0.5–2.0 mU/L','TSH/FT4: 6–8 weeks after dose change; then every 6–12 months'],['Tg/TgAb','Every 6–12 months; then every 12–24 months after excellent response','Total thyroidectomy ± RAI pathway'],['Neck ultrasound','First at 6–12 months; then every 12–24 months','Low-risk/negative-result pathway']];}
function mtcRows(){if(lang==='zh')return [['LT4/TSH','0.5–4.0 mU/L 或本实验室正常范围','TSH/FT4：调剂后6–8周；稳定后6–12个月'],['降钙素/CEA','术后2–3个月首次','建立术后基线'],['Ctn阴性/正常','Ctn+CEA：6个月×1年；之后每年','无证据复发路径'],['Ctn可测且<150 pg/mL','Ctn+CEA：每3–6个月','计算倍增时间；颈部超声每6–12个月'],['Ctn ≥150 pg/mL','颈/胸/肝/骨影像','发现后启动；之后每6–12个月或按进展']]; return [['LT4/TSH','0.5–4.0 mU/L or local reference range','TSH/FT4: 6–8 weeks after dose change; then every 6–12 months'],['Calcitonin/CEA','First at 2–3 months post-op','Postoperative baseline'],['Ctn undetectable/normal','Ctn+CEA: every 6 months for 1 year; then annually','No-evidence-of-disease pathway'],['Detectable Ctn <150 pg/mL','Ctn+CEA: every 3–6 months','Calculate doubling time; neck US every 6–12 months'],['Ctn ≥150 pg/mL','Neck/chest/liver/bone imaging','Start once detected; then every 6–12 months or per progression']];}
function atcRows(){if(lang==='zh')return [['气道/声带/吞咽','当天','初诊或症状变化当天'],['BRAF V600E/分子检测','尽快；目标≤7天','诊断同时送检'],['CT/MRI/PET-CT','基线；治疗中6–8周','局部/远处病灶评估'],['BRAF V600E阳性治疗评估','达拉非尼+曲美替尼路径','用药前；之后每2–4周毒性评估'],['LT4/TSH','0.5–4.0 mU/L 或本实验室正常范围','调剂后6–8周；稳定后6–12个月']]; return [['Airway/vocal cord/swallowing','Same day','At presentation or symptom change'],['BRAF V600E/molecular testing','ASAP; target ≤7 days','Send at diagnosis'],['CT/MRI/PET-CT','Baseline; every 6–8 weeks on treatment','Local/distant disease assessment'],['BRAF V600E-positive therapy review','Dabrafenib + trametinib pathway','Before treatment; toxicity review every 2–4 weeks'],['LT4/TSH','0.5–4.0 mU/L or local reference range','6–8 weeks after dose change; then every 6–12 months']];}
function raiRows(risk){if(lang==='zh'){
if(risk==='low')return [['RAI','不常规','术后6–12周完成初评后决定'],['Tg阈值','Tg<0.2 ng/mL（全切+RAI+TgAb阴性路径）','术后6–12个月评估'],['TgAb','同步检测','每次Tg检测同时']];
if(risk==='intermediate')return [['RAI','选择性考虑','术后6–12周完成病理/Tg/影像后'],['诊断性全身显像','9–12个月','高危特征或Tg/TgAb异常'],['TgAb','同步检测','每次Tg检测同时']];
return [['RAI','通常考虑/推荐路径','术后6–12周完成病理/Tg/影像后'],['诊断性全身显像','6–12个月','RAI后或Tg/TgAb异常'],['FDG PET/CT','Tg升高且RAI阴性时','按3–6个月进展节奏']];}
if(risk==='low')return [['RAI','Not routine','Decide after 6–12 week postoperative assessment'],['Tg threshold','Tg <0.2 ng/mL (TT + RAI + TgAb-negative pathway)','Assess at 6–12 months'],['TgAb','Measure together','With each Tg test']];
if(risk==='intermediate')return [['RAI','Selective consideration','After pathology/Tg/imaging at 6–12 weeks'],['Diagnostic whole-body scan','9–12 months','High-risk features or abnormal Tg/TgAb'],['TgAb','Measure together','With each Tg test']];
return [['RAI','Usually considered/recommended pathway','After pathology/Tg/imaging at 6–12 weeks'],['Diagnostic whole-body scan','6–12 months','After RAI or abnormal Tg/TgAb'],['FDG PET/CT','Rising Tg with negative RAI imaging','Per 3–6 month progression tempo']];}
function managementHTML(stageObj,risk){const hist=$('histology').value; const l=lang==='zh'; let html='<div class="panel-grid">';
html+=table(l?'🔪 手术方式选择':'🔪 Surgery pathway',[l?'路径':'Pathway',l?'适用数值':'Numeric criteria',l?'时间点':'Timing'],surgeryRows(),l?'手术方式不改变AJCC分期；它改变Tg/TgAb解释、RAI路径和随访间隔。':'Surgery does not change AJCC stage; it changes Tg/TgAb interpretation, RAI pathway, and follow-up intervals.',true);
if(hist==='DTC'){
html+=table(l?'💊 DTC：LT4/TSH 与随访时间':'💊 DTC: LT4/TSH and follow-up timing',[l?'项目':'Item',l?'目标值/时间':'Target/time',l?'复查间隔':'Interval'],dtcMedicationRows(risk),l?'2025 ATA DTC 更新强调：低/中危且无生化或结构复发证据时，长期低于参考范围的TSH抑制不作为常规；TSH目标需随治疗反应和心骨风险调整。':'The 2025 ATA DTC update emphasizes that long-term below-reference TSH suppression is not routine for low/intermediate-risk patients without biochemical or structural recurrence; targets are adjusted by response and cardiac/bone risk.');
html+=table(l?'🧪 DTC：RAI / Tg / TgAb':'🧪 DTC: RAI / Tg / TgAb',[l?'项目':'Item',l?'数值/路径':'Value/pathway',l?'时间点':'Timing'],raiRows(risk),l?'Tg数值必须与术式、RAI状态、TgAb阴性/阳性和TSH状态一起解释。':'Tg values must be interpreted with surgery type, RAI status, TgAb status, and TSH status.');
} else if(hist==='MTC') {
html+=table(l?'💊 MTC：LT4、降钙素、CEA':'💊 MTC: LT4, calcitonin, CEA',[l?'项目':'Item',l?'目标值/阈值':'Target/threshold',l?'复查时间':'Timing'],mtcRows(),l?'MTC不使用TSH抑制作为抗肿瘤治疗；降钙素和CEA倍增时间用于复发/进展节奏判断。':'MTC does not use TSH suppression as antitumor therapy; calcitonin and CEA doubling times help define recurrence/progression tempo.',true);
} else {
html+=table(l?'⚡ ATC：紧急评估、用药、复查':'⚡ ATC: urgent assessment, treatment, review',[l?'项目':'Item',l?'目标值/时间':'Target/time',l?'复查间隔':'Interval'],atcRows(),l?'ATC以气道安全、快速分子检测、可切除性和全身治疗窗口为核心；具体药物需按适应证和当地批准情况执行。':'ATC management centers on airway safety, rapid molecular testing, resectability, and systemic-therapy window; drugs must match indication and local approval.',true);
}
const safety = l?['TSH <0.1 mU/L：房颤/骨质疏松高风险者需单独评估。','有声音嘶哑、呼吸困难、吞咽困难、快速增大的颈部肿块：当天评估。','靶向药/免疫治疗：血压、肝肾功能、皮疹、腹泻、QT间期按药品说明书监测。']:['TSH <0.1 mU/L: separate assessment for atrial fibrillation/osteoporosis risk.','Hoarseness, dyspnea, dysphagia, or rapidly enlarging neck mass: same-day assessment.','Targeted/immunotherapy: monitor BP, liver/renal function, rash, diarrhea, and QT interval per drug label.'];
html+=card(l?'⚠️ 安全边界':'⚠️ Safety boundaries',safety,l?'这些属于风险提示，不是自动医嘱。':'These are risk prompts, not automatic medical orders.','danger-box');
html+='</div>'; return html;}
function rulesHTML(){if(lang==='zh')return `<div class="panel-grid">${card('DTC 分期',['＜55岁：M0=Ⅰ期；M1=Ⅱ期。','≥55岁：T1–2 N0 M0=Ⅰ期；T1–2 N1或T3任何N M0=Ⅱ期；T4a=Ⅲ期；T4b=ⅣA期；M1=ⅣB期。'],'AJCC8是解剖分期，不等同ATA复发风险。')}${card('MTC 分期',['T1 N0 M0=Ⅰ期。','T2–3 N0 M0=Ⅱ期。','T1–3 N1a M0=Ⅲ期。','T4a或N1b=ⅣA期；T4b=ⅣB期；M1=ⅣC期。'],'MTC不使用DTC年龄分层。')}${card('ATC 分期',['所有ATC均为Ⅳ期。','T1–3a N0 M0=ⅣA。','T3b/T4或N1 M0=ⅣB；M1=ⅣC。'],'ATC需要紧急MDT和分子检测。')}${card('未覆盖字段',['TX、T0、NX、N0a/N0b。','结外侵犯、淋巴结数量/大小、分子分型。','临床分期与病理分期差异。'],'输入不完整时应人工核实。','warn-box')}</div>`;
return `<div class="panel-grid">${card('DTC staging',['Age <55: M0=stage I; M1=stage II.','Age ≥55: T1–2 N0 M0=stage I; T1–2 N1 or T3 any N M0=stage II; T4a=stage III; T4b=stage IVA; M1=stage IVB.'],'AJCC8 is anatomic staging, not ATA recurrence-risk stratification.')}${card('MTC staging',['T1 N0 M0=stage I.','T2–3 N0 M0=stage II.','T1–3 N1a M0=stage III.','T4a or N1b=stage IVA; T4b=stage IVB; M1=stage IVC.'],'DTC age stratification does not apply to MTC.')}${card('ATC staging',['All ATC is stage IV.','T1–3a N0 M0=IVA.','T3b/T4 or N1 M0=IVB; M1=IVC.'],'ATC requires urgent MDT and molecular testing.')}${card('Not covered',['TX, T0, NX, N0a/N0b.','Extranodal extension, number/size of nodes, molecular subtype.','Clinical vs pathologic staging differences.'],'Incomplete inputs require manual verification.','warn-box')}</div>`;}
function interpretation(stageObj,risk){const l=labels[lang]; if(lang==='zh')return [`AJCC8：${stageObj.stage}。`,`TNM：${stageObj.tnm}。`,`${l.risk}：${l.riskLevels[risk]}。`,`${l.chosenSurgery}：${getText('surgeryPlan')}。`]; return [`AJCC8: ${stageObj.stage}.`,`TNM: ${stageObj.tnm}.`,`${l.risk}: ${l.riskLevels[risk]}.`,`${l.chosenSurgery}: ${getText('surgeryPlan')}.`];}
function populateOptions(){Object.keys(optionData).forEach(id=>{const sel=$(id),cur=sel.value; sel.innerHTML=optionData[id].map(o=>`<option value="${o.v}">${o[lang]}</option>`).join(''); if(cur) sel.value=cur;});}
function updateStatic(){const l=labels[lang]; document.documentElement.lang=lang==='zh'?'zh-CN':'en'; $('title').textContent=l.title; $('versionBadge').textContent=l.version; $('subhead').textContent=l.subhead; $('langBtn').textContent=l.langBtn; $('explainBtn').textContent=explainVisible?l.explainHide:l.explainShow; $('explainBtn').classList.toggle('secondary-on',explainVisible); ['printBtn','copyBtn','resetBtn','histologyLabel','ageLabel','tLabel','nLabel','mLabel','surgeryLabel','stageBadge','interpretTitle','clinicalHeader','rulesHeader','footnote'].forEach(id=>{$(id).textContent=l[id];}); $('referencesBox').innerHTML=`<strong>${l.sourceTitle}</strong><div style="margin-top:6px;">${l.sourceNote}</div><ul>${refs[lang].map(r=>`<li><a href="${r[1]}" target="_blank" rel="noopener">${r[0]}</a></li>`).join('')}</ul>`; document.body.classList.toggle('show-explain',explainVisible);}
function updateAll(){ $('ageGroup').disabled=$('histology').value!=='DTC'; const stageObj=computeStage(),risk=computeRisk(stageObj),l=labels[lang]; $('stageDisplay').textContent=stageObj.stage; $('stageDesc').textContent=stageObj.desc; $('tnmSummary').textContent=`${l.tnm}: ${stageObj.tnm}`; $('riskSummary').textContent=`${l.risk}: ${l.riskLevels[risk]}`; $('interpretList').innerHTML=interpretation(stageObj,risk).map(x=>`<li>${x}</li>`).join(''); $('stageExplain').textContent=lang==='zh'?'参考层级由本工具按分期与M状态映射，仅用于显示随访/用药模板，不等同正式复发风险分层。':'The reference tier is mapped by this tool from stage and M status only; it selects a follow-up/medication template and is not formal recurrence-risk stratification.'; $('managementPanel').innerHTML=managementHTML(stageObj,risk); $('rulesPanel').innerHTML=rulesHTML(); $('printMeta').innerHTML=`<p><strong>${l.printMeta}:</strong> ${new Date().toLocaleString(lang==='zh'?'zh-CN':'en-US')}</p><p><strong>${l.tnm}:</strong> ${stageObj.tnm} · <strong>${l.chosenSurgery}:</strong> ${getText('surgeryPlan')}</p>`; const result=$('stageResult'); if(stageObj.stage.includes('Ⅳ'))result.style.background='linear-gradient(105deg,#f7e5e8 0%,#f0d5da 100%)'; else if(stageObj.stage.includes('Ⅲ'))result.style.background='linear-gradient(105deg,#fdefe0 0%,#f8e2cf 100%)'; else result.style.background='linear-gradient(105deg,#e2f0f5 0%,#d4e9ef 100%)'; }
function reset(){ $('histology').value='DTC'; $('ageGroup').value='<55'; $('tStage').value='T1a'; $('nStage').value='N0'; $('mStage').value='M0'; $('surgeryPlan').value='notSelected'; updateAll();}
function copySummary(){const stageObj=computeStage(),risk=computeRisk(stageObj),l=labels[lang]; const text=[l.title,`${l.tnm}: ${stageObj.tnm}`,`${l.stageBadge}: ${stageObj.stage} - ${stageObj.desc}`,`${l.risk}: ${l.riskLevels[risk]}`,`${l.chosenSurgery}: ${getText('surgeryPlan')}`].join('\n'); navigator.clipboard.writeText(text).then(()=>alert(lang==='zh'?'✅ 摘要已复制':'✅ Summary copied')).catch(()=>alert(text));}
document.querySelectorAll('.section-header').forEach(h=>h.addEventListener('click',()=>{const t=$(h.dataset.target); t.classList.toggle('open'); h.querySelector('.collapse-icon').style.transform=t.classList.contains('open')?'rotate(180deg)':'rotate(0deg)';}));
['histology','ageGroup','tStage','nStage','mStage','surgeryPlan'].forEach(id=>$(id).addEventListener('change',updateAll));
$('langBtn').addEventListener('click',()=>{lang=lang==='zh'?'en':'zh'; populateOptions(); updateStatic(); updateAll();});
$('explainBtn').addEventListener('click',()=>{explainVisible=!explainVisible; updateStatic();});
$('printBtn').addEventListener('click',()=>window.print()); $('copyBtn').addEventListener('click',copySummary); $('resetBtn').addEventListener('click',reset);
populateOptions(); updateStatic(); reset();
})();
</script>
</body>
</html>