41例青少年甲状腺癌临床分析

Clinical analysis of 41 cases of thyroid carcinoma in children and adolescents

目的探讨青少年甲状腺癌的临床病理特点、外科手术方式及预后。方法41例患者均采用手术治疗,辅以内分泌治疗,4例术后^(131)Ⅰ内照射治疗。结果术后病理:乳头状腺癌33例(80.5%),滤泡状腺癌8例(19.5%)。颈部淋巴结阳性者28例(68.3%),肺转移4例。40例获5年以上随访,1例失访,5年生存率95.1%(39/41),20例获10年以上随访,10年生存率90.0%(18/ 20)。结论青少年甲状腺癌颈部肿块临床表现大多数无特异性,难以与其他颈部肿块鉴别,易误诊。治疗手段以手术为主,预后良好。具体治疗方案应根据病理类型、肿瘤范围及转移情况决定。

Objective To investigate the clinieo-pathologic characteristics, treatment and prognosis of thyroid carcinoma in children and adolescents. Methods Forty-one patients received operation and TSH suppression therapy. Four cases received the therapy with ^131I after operation. Results Pathologically, papillary carcinoma was diagnosed in 33 （ 80. 5% ）, follicular adenocarcinoma in 8 （ 19.5% ）. Cervical lymph node metastasis was found in 28 eases（68. 3% ） ,lung metastasis was found in 4 cases. All but 1 were followed up for more than 5 years. The 5-year surrival rate was 95. 1% （ 39/41 ）, 10-year surrival rate was 90. 0% （18/20）. Conclusions The clinical manifestations of childhood and adolescent thyroid carcinoma are generally not pathognostie which may lead to misdiagnosis. Surgery is the main method in the comprehensive treatment with a good prognosis. Concrete treatment plan is set according to the pathological types, extent of tumour and metastatic lesion.