儿童及青少年分化型甲状腺癌的临床病理特征分析

Clinical pathological characteristics of differentiated thyroid carcinoma in children and adolescents

目的探讨儿童及青少年分化型甲状腺癌的临床病理特征。方法回顾性分析30例儿童及青少年分化型甲状腺癌患者的临床资料,并结合年龄和性别因素对分化型甲状腺癌的临床病理特征进行分析。结果甲状腺乳头状癌27例,甲状腺滤泡状癌3例,肿瘤平均直径为(2.56±1.1)cm。儿童组中淋巴结转移率92.3%(12/13),肺转移率46.2%(6/13);青少年组淋巴结转移率88.2%(15/17),肺转移率35.3%(6/17)。儿童组患者病灶更容易发生脉管癌栓、甲状腺被膜侵犯及甲状腺外侵犯,出现颈侧区淋巴结转移的几率更高,差异有统计学意义。结论儿童及青少年分化型甲状腺癌患者的侵袭性强,容易出现局部侵犯、淋巴结及远处转移,儿童患者比青少年患者侵袭性更强。

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma （DTC） in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients＇ age and gender. RESULTS Papillary thyroid carcinoma （PTC） was found in 27 cases and follicular thyroid carcinoma （FTC） in 3 cases. The average diameter of tumors was （2.56±1.1） cm. In the group of children, the incidence of lymph node metastasis was 92.3% （12/13）, pulmonary metastasis was 46.2% （6/13）, and those in the group of adolescents was 88.2% （15/17） and 35.3% （6/17） respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis （P=0.025, 0.007, 0.025, 0.033）. CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.