Kasahara Toshihiko, Miyauchi Akira, Kudo Takumi, Nishihara Eijun, Ito Mitsuru, Ito Yasuhiro, Kihara Minoru, Miya Akihiro
Department of Internal Medicine, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan.
Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan.
J Thyroid Res. 2018 May 16;2018:6470251. doi: 10.1155/2018/6470251. eCollection 2018.
Children and adolescents with papillary thyroid carcinomas (PTCs) have generally excellent prognoses despite their frequent extended disease. The tumor growth of young patients' PTCs might show spontaneous slowing postoperatively. We compared young PTC patients' postoperative thyroglobulin-doubling time (Tg-DT) with their preoperative hypothetical tumor volume-doubling time (hTV-DT).
Fourteen PTC patients aged ≤18 years who underwent total thyroidectomy at Kuma Hospital in 1998-2016 had biochemically persistent disease postoperatively. We calculated their Tg-DTs and estimated their preoperative TV-DTs with the tumor size and the patient's age at surgery, presuming that a single cancer cell was present at the patient's birth.
Twelve patients had positive Tg-DTs ranging from 2.0 to 147 years, and the remaining two had negative Tg-DTs, indicating slow growth or even regression. The hTV-DTs were 0.3-0.6 years (median 0.5 years), which were significantly shorter than the Tg-DTs ( < 0.001), indicating much faster growth preoperatively. The analyses of the nine patients without radioactive iodine administration (RAI) gave similar results ( < 0.01).
Irrespective of RAI, the patients' postoperative Tg-DTs were significantly longer than their preoperative hTV-DTs and were negative values in two patients, indicating that the growth of these young patients' PTCs had spontaneously slowed or even regressed postoperatively.
甲状腺乳头状癌（PTC）患儿和青少年患者，尽管疾病常呈进展性，但总体预后通常良好。年轻患者的PTC肿瘤生长在术后可能会出现自发减缓。我们比较了年轻PTC患者术后甲状腺球蛋白倍增时间（Tg-DT）与其术前假设的肿瘤体积倍增时间（hTV-DT）。
1998年至2016年在熊本医院接受全甲状腺切除术的14例年龄≤18岁的PTC患者术后生化检查提示疾病持续存在。我们计算了他们的Tg-DT，并根据肿瘤大小和手术时患者年龄估算了术前的TV-DT，假定患者出生时存在单个癌细胞。
12例患者的Tg-DT为阳性，范围为2.0至147年，其余2例为阴性，表明生长缓慢甚至消退。hTV-DT为0.3 - 0.6年（中位数0.5年），显著短于Tg-DT（<0.001），表明术前生长快得多。对9例未接受放射性碘治疗（RAI）的患者进行分析，结果相似（<0.01）。
无论是否接受RAI治疗，患者术后的Tg-DT均显著长于术前hTV-DT，且2例患者为负值，表明这些年轻患者的PTC术后生长自发减缓甚至消退。
