青少年甲状腺癌的诊断与治疗  

Diagnosis and treatment of thyroid carcinoma in childhood and adolescents

作　　者：毛岸荣[1] 施俊义[1] 盛援[1] 马立业[1] 毕建威[1] 方国恩[1] 

机构地区：[1]第二军医大学附属长海医院普外四科,上海200433

出　　处：《临床外科杂志》2008年第6期381-383,共3页Journal of Clinical Surgery

摘　　要：目的讨论青少年甲状腺癌的临床表现、诊断、治疗及预后。方法收集我院1990年至2000年青少年甲状腺癌56例,均行手术治疗,术后行内分泌辅助治疗,少数加用131I内照射。结果全组乳头状癌44例(78.6%),滤泡状癌8例(14.3%),乳头滤泡状癌2例(3.6%),髓样癌2例(3.6%)。颈部淋巴结转移40例(71.4%),其中双侧甲状腺癌并双侧颈部淋巴结转移者8例(14.2%)。术后复发9例(16.1%)。本组颈部淋巴结转移率、双侧甲状腺受侵犯伴双颈淋巴结转移率均明显高于成年人,5年生存率92.9%(52/56)。结论青少年甲状腺癌颈部肿块临床表现大多数无特异性,常以颈部肿大淋巴结或甲状腺孤立结节就诊,不易早发现易误诊,应引起我们的高度重视。治疗以手术为主,预后良好,疗效满意。Objective To discuss the clinical characteristics,diagnosis,treatment and prognosis of thyroid carcinoma in childhood and adolescents. Methods From 1990 to 2000,56 cases of thyroid carcinoma in childhood and adolescents were treated with surgical opration and afterwards with adju- vant incretional therapy and little with ^131I. Results Papillary carcinoma was diagnosed in 44 （78.6%） ,follicular carcinoma in 8 （ 14.35% ）, papillaryfollicular carcinoma in 2 （7.1%） and medul- lary carcinoma in 3 （ 3.5% ）. Cervieal lymph node metastasis was found in 40 cases （ 71.4% ） , of which with both thyroid carcinoma and bilateral cervical lymphnode metastasis in 8 cases （ 14.2% ）. Recurrence occurred in 9 cases after surgical operation. Compared with the thyroid carcinoma in adult patients, cervical lymph node metastasis, bilateral involvement of the thyroid and bilateral cervical nodes were more than in childhood and adolescence. The 5 - year survival rate was 92.9% （52/56）. Conclusion The clinical characteristics of thyroid carcinoma in childhood and adolescents are generally not special and not found early and easily. Surgical management is the main method and the prognosis is favorable.

关 键 词：甲状腺肿瘤 淋巴结转移 外科手术 

分 类 号：R736.1[医药卫生—肿瘤]