儿童及青少年甲状腺癌特点及颈淋巴结转移风险因素探讨

目的:探讨儿童及青少年甲状腺癌的临床和病理特征,分析乳头状癌组淋巴结转移的风险因素。方法:回顾性分析2003年1月至2013年12月间本院收治的儿童及青少年甲状腺癌病例资料,了解临床特征和病理特点及分析乳头状癌亚组淋巴结转移的风险因素。结果:共收集51例儿童及青少年甲状腺癌资料,49例甲状腺乳头状癌,2例甲状腺髓样癌。乳头状癌亚组淋巴结转移率达77.5%,患儿年龄与淋巴结转移相关,Logistic回归提示年龄是颈部淋巴结转移的独立风险因素(OR=1.40;95%CL=1.05,1.85;P=0.021)。随访中5例出现局部复发。结论:儿童及青少年甲状腺癌有区别于成人甲状腺癌的特殊性,积极筛查儿童甲状腺疾病、全面彻底的外科手术和制定相应的风险评估标准、积极随访是治疗该病的关键。

Study of Characteristics of Thyroid Cancer and Risk Factors of Cervical Lymph Node Metastasis in Children and Adolescence

Objective:To investigate the clinical and pathological characteristics of thyroid cancer in children and adolescence, analysis the risk factors of cervical lymph node metastasis (CLNM) in papillary thyroid cancer (PTC) group.Methods:A retrospective clinical study was performed of children and adolescence with thyroid cancer in Tongji Hospital from January 2003 to December 2013. The clinical and pathological characteristics were noted, and the risk factors of CLNMin PTC were analyzed especially.Results:51 cases were noted in our department, 49 cases were papillary thyroid carcinoma, 2 cases were medullary thyroid carcinoma. In PTC group, the rate of CLNMwas 77.5 %, and there was a correlation between age and CLNM, Multivariate Logistic Regression showed that age has an independent effect on CLNM in PTC group (OR=1.40, 95% CL=1.05, 1.85; P=0.021).Conclusion:Thyroid cancer in children and adolescence has some special features compared with that in adults. The key to treat this disease is screening thyroid disease in this group, performing comprehensive surgical operation, appropriate post-operative treatment, and formulating a special risk assessment criterion and proper follow-up.