儿童及青少年甲状腺乳头状癌的术前超声声像及术后病理特征分析

Ultrasonographic and Pathologic Findings of Papillary Thyroid Carcinoma Arising in Children and Adolescents

儿童和青少年的甲状腺癌较为罕见,二者在超声及病理特征方面均存在差异。本研究回顾分析了34例病理证实为乳头状甲状腺癌的儿童与青少年患者的术前超声检查表现和术后病理特征,比较了这两者的差异。结果发现儿童组(≤15岁)与青少年组(15~18岁)的男女比例分布是3∶5和1∶17(P=0.020);超声发现微钙化的占比分别是93.8%和50.0%(P<0.001);超声发现淋巴转移的占比分别是87.5%和44.4%(P=0.028);TI-RADS分类中5类结节的占比分别是93.8%和50.0%(P=0.026);术后病理结果中N0、N1a、N1b的比例分别是4∶5∶7和6∶11∶1(P=0.029);手术后病理分期(pTNM)分别是Ⅰ∶Ⅱ=8∶8和15∶3(P=0.038)。上述结果说明,儿童较青少年PTC患者中,男性发病率更高,多表现为超声微钙化和TI-RADS分类为5类的结节,淋巴结转移发生率高,病理Ⅱ期pTNM分期较多。

Children and adolescents with papillary thyroid carcinoma(PTC)are rare,but their differences in sonographic and pathologic features are significant.A total of 34consecutive patients including pathologically confirmed children(age≤15years)and adolescents(15-18years)with papillary thyroid carcinoma(PTC)were recruited.We retrospectively analyzed the preoperative ultrasonography and pathology features,compared the difference of them.The incidence of gender in children and adolescents(male vs.female)were 3∶5 vs.1∶17(P=0.020).Moreover,the presence of punctate echogenic foci on sonography was 93.8%vs.50.0%.The presence of neck lymph node metastasis was 87.5%vs.44.4%,and the ratio of category 5nodules in ACR TI-RADS was 93.8%vs.50.0%in children and adolescents patients(P<0.05).The histopathology ratio of staging N0,N1aand N1bin children and adolescent groups were 4∶5∶7and 6∶11∶1(P=0.029),the ratio of pTNM stagingⅠandⅡwere 8∶8and 15∶3(P=0.038),respectively.In conclusion,the PTC in children have specific ultrasonography and pathology features,which were different from those of adolescent.