Qu Yuan, Huang Rui, Li Lin
Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.
J Paediatr Child Health. 2017 Sep;53(9):903-907. doi: 10.1111/jpc.13569.
To investigate the factors that influence disease progression of paediatric patients with differentiated thyroid carcinoma.
A total of 34 patients under 18 years of age with differentiated thyroid carcinoma (32 papillary and 2 follicular; 9 males and 25 females; 19 cases younger than 15 years old and 15 cases 15-18 years old) treated in our department from June 2009 to August 2015 were retrospectively reviewed. All of the patients underwent a total thyroidectomy or near-total thyroidectomy, central node dissection and/or lateral neck dissection, radioactive iodine treatment and thyroid-stimulating hormone suppressive therapy. A univariate analysis was conducted by log-rank to evaluate the factors that influenced progression-free survival of differentiated thyroid carcinoma in these patients.
The median progression-free survival time of all patients was 23 months, ranging from 4 to 72 months. Progression of pulmonary metastatic disease was observed in two cases, a recurrence in the thyroid bed was found in one case, and thyroglobulin significantly increased in four cases. In the univariate analysis, the factor that influenced progression-free survival of differentiated thyroid carcinoma was multifocality (P = 0.040), and independently, age, gender, tumour size, pathological type, degree of infiltration, lymph node metastasis and pulmonary metastasis had no significant influence on progression-free survival (P > 0.05).
Multifocality was the factor that influenced the progression-free survival of differentiated thyroid carcinoma patients under 18 years of age.
探讨影响分化型甲状腺癌儿科患者疾病进展的因素。
回顾性分析2009年6月至2015年8月在我科接受治疗的34例18岁以下分化型甲状腺癌患者(32例乳头状癌和2例滤泡状癌;9例男性和25例女性;19例年龄小于15岁,15例年龄在15 - 18岁)。所有患者均接受了全甲状腺切除术或近全甲状腺切除术、中央区淋巴结清扫和/或侧颈淋巴结清扫、放射性碘治疗及促甲状腺激素抑制治疗。采用对数秩检验进行单因素分析,以评估影响这些患者分化型甲状腺癌无进展生存期的因素。
所有患者的中位无进展生存时间为23个月,范围为4至72个月。观察到2例发生肺转移,1例甲状腺床复发,4例甲状腺球蛋白显著升高。单因素分析中,影响分化型甲状腺癌无进展生存期的因素为多灶性(P = 0.040),而年龄、性别、肿瘤大小、病理类型、浸润程度、淋巴结转移和肺转移对无进展生存期无显著影响(P > 0.05)。
多灶性是影响18岁以下分化型甲状腺癌患者无进展生存期的因素。