老年甲状腺乳头状癌患者临床特点分析

To analyze the clinical characteristics of elderly patients with papillary thyroid carcinoma

目的以年龄分组方式分析甲状腺乳头状癌(PTC)老年患者的临床特点。方法回顾性分析2019年12月至2021年12月就诊于北京医院甲状腺外科的652例PTC患者的临床资料,将患者分为老年组(≥60岁,90例)、中年组(40~59岁,359例)和青年组(<40岁,203例),利用统计学方法分析不同组年龄患者的临床特点、超声特征及侵袭性相关因素。结果与中、青年组相比,PTC老年患者中微小癌比例更高(75.6%,75.2%,61.4%,χ^(2)=13.054,P=0.001),发生颈部淋巴结转移更少(24.4%,34.3%,58.1%,χ^(2)=41.650,P<0.001),转移淋巴结的比例更低(0.08,0.14,0.24,χ^(2)=40.618,P<0.001),不同年龄组肿瘤位置及腺外侵犯情况差异无统计学意义(35.56%,36.2%,38.4%,χ^(2)=0.959,P=0.545)。结论与中、青年组相比,PTC在老年人群中呈现侵袭性低的特点。在积极手术治疗的同时,对于具有低风险临床特点的老年患者,经综合评估后是否可选择谨慎观察或姑息性治疗的诊疗方式值得进一步研究。

Objective To analyze the clinical characteristics of elderly patients with papillary thyroid cancer(PTC)by age grouping.Methods The patients were divided into three groups according to age at diagnosis:old(≥60 years,90 cases),middle(40-59 years,359 cases)and young patients(<40 years,203 cases).The clinical data of 652 patients with PTC who were admitted to the Department of Thyroid Surgery of Beijing Hospital from December 2019 to December 2021 were retrospectively analyzed.The patients were divided into elderly group(≥60 years old,90 cases),middle-aged group(40-59 years old,359 cases)and young group(<40 years old,203 cases).The clinical characteristics,ultrasound characteristics and invasion-related factors of patients in different groups were analyzed by statistical methods.Results Compared with the young and middle-aged group,the elderly patients with PTC had a higher proportion of microcarcinoma(75.6%,75.2%,61.4%,χ^(2)=13.054,P=0.001),less cervical lymph node metastasis(24.4%,34.3%,58.1%,χ^(2)=41.650,P<0.001),and lower proportion of metastatic lymph nodes(0.08,0.14,0.24,χ^(2)=40.618,P<0.001).There was no significant difference in tumor location and extra glandular invasion among the three age groups(35.56%,36.2%,38.4%,χ^(2)=0.959,P=0.545).Conclusions Compared with the young and middle-aged groups,PTC showed low invasiveness in the elderly population.In addition to surgical treatment,for elderly patients with low-risk clinical characteristics,it is worth performing a further study on whether careful observation or palliative treatment can be selected after comprehensive evaluation.