[1]孙 浩),贺春雨)#,李 潜),等.儿童分化型甲状腺癌临床特征及预后分析*[J].郑州大学学报(医学版),2017,(06):746-749.[doi:10.13705/j.issn.1671-6825.2017.06.020]
 SUN Hao),HE Chunyu),LI Qian),et al.Presentation and clinical outcome of differentiated thyroid cancer in children[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(06):746-749.[doi:10.13705/j.issn.1671-6825.2017.06.020]
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儿童分化型甲状腺癌临床特征及预后分析*()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年06期
页码:
746-749
栏目:
应用研究
出版日期:
2017-11-15

文章信息/Info

Title:
Presentation and clinical outcome of differentiated thyroid cancer in children
作者:
孙 浩1)贺春雨1)#李 潜2)崔 萌3)刘 如1)代立媛3)刘海龙1)
1)郑州大学附属肿瘤医院放疗中心 郑州 450008
2)郑州大学附属肿瘤医院超声科 郑州 450008
3)郑州大学附属肿瘤医院头颈甲状腺科 郑州 450008
Author(s):
SUN Hao1)HE Chunyu1) LI Qian2) CUI Meng3)LIU Ru1) DAI Liyuan3)LIU Hailong1)
1)Centre of Radiation Oncology, the Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou 450008
2)Department of Ultrasound,the Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou 450008
3)Department of Head Neck and Thyroid Surgery,the Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou 450008
关键词:
分化型甲状腺癌 儿童 临床特征 生存分析
Keywords:
differentiated thyroid cancer children clinical outcome survival analysis
分类号:
R736.1
DOI:
10.13705/j.issn.1671-6825.2017.06.020
摘要:
目的:分析儿童分化型甲状腺癌的临床特征、治疗方法及其预后,探讨最佳治疗方法。方法:回顾性分析38例儿童甲状腺癌患者(≤14岁)的临床、影像、病理特征、治疗方法及转归,应用Kaplan-Meier进行生存分析。结果:38例儿童甲状腺癌男女性别比为1GA6FA1.7,中位年龄(四分位数)为12(6,14)岁。所有患者均以发现颈部肿块为主诉,B超发现微小钙化为儿童甲状腺癌最具特征表现。29例(76.3%)接受甲状腺次全切除术,9例(23.7%)行甲状腺全切除术。33例(86.2%)颈淋巴结转移,6例(15.8%)在手术时有肺转移。38例患者中13例(34.2%)出现术后颈部复发或转移。2例患儿死于甲状腺癌,1例死于其他疾病。中位随访时间(四分位数)为88(37,156)个月,全组5 a生存率、10 a总生存率、无复发/转移生存率分别为96.88%、86.28%,64.35%和60.32%。结论:儿童分化型甲状腺癌具有高度侵犯特征,在诊断时往往局部侵犯和颈部淋巴结或远处转移,复发率较高,但病死率低,预后良好; 甲状腺全切或次全切除术联合颈清扫术是治疗的关键。
Abstract:
Aim: To evaluate the presentation, clinical course and outcome of differentiated thyroid cancer(DTC)in children.Methods: From January 2002 to December 2015, patients(age≤14 year)with DTC in Henan Tumor Hospital were identified and retrospectively reviewed. The clinical characteristics and outcome were analyzed, and the progression-free survival(PFS)and overall survival(OS)were evaluated using the Kaplan-Meier method.Results: The ratio of male to female was 1GA6FA1.7 and the median age at diagnosis was 12(6,14)year. Neck mass was the chief complaint in all patients.The most characteristic ultrasonographic feature was microcalcification. A total of 29 patients(76.3%)underwent less than total thyroidectomy and 9(23.7%)underwent total thyroidectomy. A total of 33 patients(86.2%)had neck lymph node metastasis and 6(15.8%)had lung metastasis at the time of surgery. Among the 38 patients, recurrence or metastasis occurred in 13 patients(34.2%). Two patients died of thyroid carcinoma and one patient died of other disease. Mean follow-up period was 88(37,156)months. The 5,10-year overall survival rate and recurrence free survival rate were 96.88% and 86.28%, 64.35% and 60.32%, respectively.Conclusion: The children with DTC had a high frequency of lymph node and distant metastasis with high reeurrence rate. the prognosis is excellent for pediatric patients, with a low mortality rate. It is recommended that pediatric thyroid cancer should be managed mostly using proper surgical approach with thyroidectomy and lymph node dissection when indicated.

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备注/Memo

备注/Memo:
* 河南省科技厅一般项目 142300410382
#通信作者,男,1980年6月生,博士,副主任医师,研究方向:头颈部肿瘤的放射治疗,E-mail:alexander1001@126.com
更新日期/Last Update: 2017-11-20