青少年分化型甲状腺癌的临床特点及治疗选择  

Differentiated thyroid carcinoma in children and adolescents: clinical characteristics and treatment

作　　者：龚建平[1] 张仁希[1] 陈环球[1] 蒋谦[1] 王太洪[1] 陆保成[1] 

机构地区：[1]江苏省肿瘤医院普外科,南京210009

出　　处：《中华外科杂志》2006年第21期1483-1485,共3页Chinese Journal of Surgery

摘　　要：目的探讨青少年分化型甲状腺癌的临床病理特点、治疗及预后。方法回顾性分析我院1979年至2004年收治的18岁以下青少年分化型甲状腺癌46例患者的临床病理资料。结果全组患者术前误诊20例（43．5％）。所有患者均行手术治疗，其中颈清扫术45例，单侧颈清扫术39例，双侧颈清扫术6例。术后病理示乳头状腺癌42例（91．3％）；滤泡状腺癌4例（8．7％）；颈淋巴结阳性者39例（84．8％）。患者术后均口服甲状腺素片；平均随访近10年（1～25年），无一例因该病死亡。结论青少年分化型甲状腺癌易误诊，多为乳头状癌，尽管颈部淋巴结转移率高，但预后较好。重视其临床特点结合一定的辅助检查，可望减少误诊，达到早诊早治的目的；选择合理术式及术后治疗可取得满意疗效。Objective To explore the clinicopathologic characteristics, treatment and prognosis of differentiated thyroid carcinoma （DTC） in adolescents. Methods The data of 46 patients with DTC under the age of 18 years were retrospectively reviewed. Results Twenty patients were misdiagnosed in this group （43.5%）. All patients recieved operation, including 39 unilateral neck dissection and 6 bilateral neck dissection, followed by postoperative thyrotropin suppressive therapy. There were 42 cases of papillary carcinoma（91.3% ） and 4 cases of follicular carcinoma（ 8.7% ）. Cervical lymph node metastasis was found in 39 cases （84. 8% ）. In the follow-up period of 1 to 25 years （mean 10 years）, no death of thyroid carcinoma occured. Conclusions The most common DTC in adolescents is papillary carcinoma with better prognosis regardless of the higher incidence of cervical lymph node metastasis. The optimal extent of primary thyroidectomy and neck dissection followed by postoperative thyrotropin suppressive therapy in adolescents with DTC may improve the quality of life and decrease the incidence of complications.

关 键 词：甲状腺肿瘤 青少年 治疗 预后 

分 类 号：R736.1[医药卫生—肿瘤]