Lebbink Chantal A, van den Broek Medard F M, Kwast Annemiek B G, Derikx Joep P M, Dierselhuis Miranda P, Kruijff Schelto, Links Thera P, van Trotsenburg A S Paul, Valk Gerlof D, Vriens Menno R, Verrijn Stuart Annemarie A, van Santen Hanneke M, Karim-Kos Henrike E
Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB Utrecht, The Netherlands.
Princess Máxima Center for Pediatric Oncology, 3508 AB Utrecht, The Netherlands.
Cancers (Basel). 2021 Oct 12;13(20):5104. doi: 10.3390/cancers13205104.
Thyroid cancer is the most common endocrine malignancy in children. A rising incidence has been reported worldwide. Possible explanations include the increased use of enhanced imaging (leading to incidentalomas) and an increased prevalence of risk factors. We aimed to evaluate the incidence and survival trends of thyroid cancer in Dutch children, adolescents, and young adults (0-24 years) between 1990 and 2019. The age-standardized incidence rates of differentiated thyroid cancer (DTC, including papillary and follicular thyroid cancer (PTC and FTC, respectively)) and medullary thyroid cancer (MTC), the average annual percentage changes (AAPC) in incidence rates, and 10-year overall survival (OS) were calculated based on data obtained from the nationwide cancer registry (Netherlands Cancer Registry). A total of 839 patients aged 0-24 years had been diagnosed with thyroid carcinoma (PTC: 594 (71%), FTC: 128 (15%), MTC: 114 (14%)) between 1990 and 2019. The incidence of PTC increased significantly over time (AAPC +3.6%; 95%CI +2.3 to +4.8), the incidence rate of FTC showed a stable trend ((AAPC -1.1%; 95%CI -3.4 to +1.1), while the incidence of MTC decreased significantly (AAPC: -4.4% (95%CI -7.3 to -1.5). The 10-year OS was 99.5% (1990-1999) and 98.6% (2000-2009) in patients with DTC and 92.4% (1990-1999) and 96.0% (2000-2009) in patients with MTC. In this nationwide study, a rising incidence of PTC and decreasing incidence of MTC were observed. For both groups, in spite of the high proportion of patients with lymph node involvement at diagnosis for DTC and the limited treatment options for MTC, 10-year OS was high.
甲状腺癌是儿童中最常见的内分泌系统恶性肿瘤。据报道，全球范围内其发病率呈上升趋势。可能的解释包括增强成像技术使用增加（导致偶发瘤）以及风险因素的患病率上升。我们旨在评估1990年至2019年间荷兰儿童、青少年和青年（0至24岁）甲状腺癌的发病率和生存趋势。根据从全国癌症登记处（荷兰癌症登记处）获得的数据，计算了分化型甲状腺癌（DTC，包括乳头状甲状腺癌和滤泡状甲状腺癌（分别为PTC和FTC））和髓样甲状腺癌（MTC）的年龄标准化发病率、发病率的年均变化百分比（AAPC）以及10年总生存率（OS）。1990年至2019年间，共有839名0至24岁的患者被诊断为甲状腺癌（PTC：594例（71%），FTC：128例（15%），MTC：114例（14%））。PTC的发病率随时间显著增加（AAPC +3.6%；95%CI +2.3至+4.8），FTC的发病率呈稳定趋势（（AAPC -1.1%；95%CI -3.4至+1.1），而MTC的发病率显著下降（AAPC：-4.4%（95%CI -7.3至-1.5）。DTC患者的10年OS在1990 - 1999年为99.5%，在2000 - 2009年为98.6%；MTC患者的10年OS在1990 - 1999年为92.4%，在2000 - 2009年为96.0%。在这项全国性研究中，观察到PTC发病率上升而MTC发病率下降。对于这两组患者，尽管DTC诊断时伴有淋巴结受累的患者比例较高，且MTC的治疗选择有限，但10年OS率较高。
