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儿童及青少年甲状腺癌:来自两个中心的临床特征及随访情况

Thyroid carcinoma in children and adolescents: Clinical characteristics and follow-up from two centers.

作者信息

Pan Jing-Jing, Zhao Li, Cheng Rui, Yang Yang, Hu Yu-Hua

机构信息

Department of Pediatrics and Neonatology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210008, Jiangsu Province, China.

Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing 210008, Jiangsu Province, China.

出版信息

J Cancer Res Ther. 2017;13(4):715-719. doi: 10.4103/jcrt.JCRT_167_16.

DOI:10.4103/jcrt.JCRT_167_16
PMID:28901320
Abstract

AIM OF STUDY

The aim of this study was to analyze the clinical features and outcomes of thyroid carcinoma (TC) in children and adolescent population treated in our institution.

MATERIALS AND METHODS

We gathered 43 TC patients 18 years of age or under initial diagnosed between 2009 and 2010 from two hospitals. Patient's clinical characteristics, laboratory tests, and outcomes were collected and analyzed.

RESULTS

(1) The incidence of TC is higher in women (2.4 vs. 1.6). Papillary carcinoma accounted for the major type (67.4%). There was significant difference in tumor number, extra thyroidal invasion, and distant metastasis when compared with the children group (P < 0.05). There were higher proportions of patients with lymph node metastasis (LNM) and radioiodine therapy in adolescent patients. (2) Thyroid peroxidase antibody, thyroglobulin, thyroglobulin antibody, and urine iodine had higher levels as compared to the normal reference range. Moreover, FT3 and urine iodine showed statistical significances in adolescent group (P < 0.05). (3) Papillary carcinoma and medullary TC are more likely to have LNM extrathyroidal invasion. (4) No significant differences were seen in recurrence rate or survival rate. Pulmonary metastasis was the most common way of cancer metastasis.

CONCLUSION

The initial workup is crucial in determining benign from malignant lesions. Surgery is the most effective therapy even if it is associated with more complications in children. There is an extremely good prognosis for pediatric TC even distant metastasis happens.

摘要

研究目的

本研究旨在分析在我院接受治疗的儿童及青少年甲状腺癌(TC)的临床特征及治疗结果。

材料与方法

我们收集了2009年至2010年间首次诊断的43例18岁及以下的TC患者,这些患者来自两家医院。收集并分析了患者的临床特征、实验室检查及治疗结果。

结果

(1)TC的发病率女性高于男性(2.4比1.6)。乳头状癌为主要类型(67.4%)。与儿童组相比,肿瘤数量、甲状腺外侵犯及远处转移存在显著差异(P<0.05)。青少年患者中淋巴结转移(LNM)及放射性碘治疗的比例更高。(2)甲状腺过氧化物酶抗体、甲状腺球蛋白、甲状腺球蛋白抗体及尿碘水平高于正常参考范围。此外,FT3及尿碘在青少年组有统计学意义(P<0.05)。(3)乳头状癌及髓样TC更易发生LNM及甲状腺外侵犯。(4)复发率及生存率未见显著差异。肺转移是最常见的癌症转移途径。

结论

初始检查对于鉴别良性与恶性病变至关重要。手术是最有效的治疗方法,即便手术在儿童中会伴有更多并发症。儿童TC即便发生远处转移预后也非常好。

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