儿童及青少年分化型甲状腺癌的临床特征及^131I治疗分析  

Analysis on the childhood and adolescent differentiated thyroid cancer： clinical features and radioiodine treatment

作　　者：陈泽泉[1] 罗全勇[1] 陈立波[1] 丁颖[1] 余永利[1] 陆汉魁[1] 朱瑞森[1] 

机构地区：[1]上海交通大学附属第六人民医院核医学科,200233

出　　处：《中华核医学杂志》2009年第3期153-155,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨儿童及青少年分化型甲状腺癌（DTC）的特征及评价^131I治疗的疗效及安全性。方法共38例儿童及青少年DTC患者，平均年龄16．4岁，男10例，女28例，男女比例为1：2．8；其中37例为乳头状癌，1例为滤泡状癌。所有患者均伴有淋巴结转移，其中单纯淋巴结转移21例，合并肺转移15例，同时合并脑转移和骨转移2例。23例行双侧甲状腺全切除，7例行甲状腺次全切除，5例行单叶甲状腺切除，2例行部分甲状腺切除，1例行单纯肿瘤切除。所有患者术后均接受^131I治疗，并进行随访。结果^131I治疗后随访1—17年，无瘤生存14例，病情明显缓解16例，病情稳定8例。所有患者未出现新的转移及继发肿瘤。结论儿童及青少年DTC易转移及复发，术后行^131I治疗安全有效，可明显改善患者生存质量。Objective Children with differentiated thyroid cancer （DTC） frequently present with more extensive disease than adults. The aim of this study was to characterize the clinical features of childhood and adolescent DTC and evaluate the outcome and safety of radioiodine treatment. Methods The records of 38 childhood and adolescent DTC cases, with 28 females and 10 males （mean age： 16.4 years） were reviewed. At diagnosis, all had metastatic lesions with 38 at regional lymph nodes, 15 at lung, 2 at brain and bone. Twenty-three had a total thyroidectomy, 7 had subtotal thyroidectomy, 5 had lobectomy, and 3 had other treatment. All received post-operative radioiodine therapy. All had follow-up for at least one year. Results At the time of follow-up, all were survive （with a median follow-up of 5.13 years）. Fourteen patients had no evidence of disease, 16 had partial remission, and 8 were stable disease. Conclusions DTC of the thyroid in childhood and adolescent has high risks of residual/recurrence and metastasis. Postthyroidectomy oral administration of radioiodine was an effective and safety adjuvant therapy for outcomes.

关 键 词：甲状腺肿瘤 儿童 青少年 放射疗法 碘放射性同位素 

分 类 号：R686[医药卫生—骨科学]