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影响儿童分化型甲状腺癌疾病进展因素的临床分析

Clinical analysis of the factors that influence disease progression of differentiated thyroid carcinoma in children.

作者信息

Qu Yuan, Huang Rui, Li Lin

机构信息

Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.

出版信息

J Paediatr Child Health. 2017 Sep;53(9):903-907. doi: 10.1111/jpc.13569.

Abstract

AIM

To investigate the factors that influence disease progression of paediatric patients with differentiated thyroid carcinoma.

METHODS

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.

RESULTS

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).

CONCLUSION

Multifocality was the factor that influenced the progression-free survival of differentiated thyroid carcinoma patients under 18 years of age.

摘要

目的

探讨影响分化型甲状腺癌儿科患者疾病进展的因素。

方法

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。

结果

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)。

结论

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。

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