106例青少年甲状腺癌临床分析

Clinical Analysis of 106 Cases with Adolescent Thyroid Carcinoma

[目的]探讨青少年期甲状腺癌的临床特点、诊治及预后.[方法]回顾性分析1980～1999年间收治的20岁以下青少年期甲状腺癌106例.[结果]全组均行手术治疗,106例青少年甲状腺癌中,乳头状腺癌84例,滤泡状癌10例,髓样癌11例,未分化癌1例.伴颈淋巴结转移者81例,其中双侧甲状腺癌并双颈淋巴结转移24例,占22.6%.手术方式包括甲状腺患侧腺叶加峡部切除70例(其中行患侧功能性颈清扫65例),患侧腺叶加峡部切除及对侧大部切除26例(行单侧颈清扫8例,双侧颈清扫14例);甲状腺全切术加双侧颈清扫术10例.术后均予甲状腺素内分泌抑制治疗.随访时间5年至24年,其中72例获得10年以上随访.5年生存率96.2%,10年生存率88.9%.[结论]青少年甲状腺癌预后较佳,治疗的关键是正确根据其病理类型和病情选择合适的手术方式.

To study the clinical characteristics,diagnosis,treatment and prognosis of adolescent thy-roid carcinoma.The records of106cases of adolescent thyroid carcinoma under20years old be-tween1980and1999were reviewed.All patients underwent surgical treatment.Treatment consisted of a lobectomy in70cases(65cases received neck dissection),subtotal thyroidectomy in26cases(unilateral dissection in8and bilateral dissection in14cases),total thyroidectomy and bilateral dissection in10cases.The pathological revealed papillary carcinoma84cases,follicular carcinoma10cases,medullary carcinoma11cases and anaplastic carcinoma1case.Cervical lymph node metastasis was found in81cases,24of them with bilateral cervical lymph node metastasis.All106patients received postoperative thyroid hormone suppres-sive therapy.The follow-up period was5to24years(with72cases over10years),and the5-and10-year survival rates were96.2%and88.9%,respectively.[Conclusion]Carcinoma of the thyroid in adolescent has little risk of mortality.A proper surgical process is the key point of the comprehensive treatment to get a good outcome.