儿童和青少年分化型甲状腺癌肺转移的影响因素研究  

Influencing factors for lung metastasis of differentiated thyroid carcinoma in children and adolescents

作　　者：孙可微 楼建林[2] 沈佳菲 徐栋[1] SUN Kewei;LOU Jianlin;SHEN Jiafei;XU Dong(Department of Ultrasound,Zhejiang Cancer Hospital,Hangzhou 310022,China;不详)

机构地区：[1]浙江省肿瘤医院超声科,杭州310022 [2]浙江省肿瘤医院头颈外科,杭州310022

出　　处：《浙江医学》2024年第17期1835-1839,共5页Zhejiang Medical Journal

基　　金：国家自然科学基金项目(82071946)。

摘　　要：目的探讨儿童和青少年(年龄≤18岁)分化型甲状腺癌肺转移的影响因素。方法回顾性选择2010年1月至2022年10月在浙江省肿瘤医院确诊并接受手术治疗的儿童和青少年分化型甲状腺癌患者255例。依据是否发生肺转移分为观察组45例和对照组210例。比较两组患者临床、超声和病理特征,并采用单因素和多因素logistic回归分析发生肺转移的独立影响因素。结果观察组年龄小于对照组,术后高刺激性甲状腺球蛋白(sTg)患者占比、肿瘤直径、毛刺样结构占比大于对照组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,术后高sTg、肿瘤直径较大、肿瘤多灶性、甲状腺外侵犯、淋巴结转移(中央区+侧颈部)均是儿童和青少年分化型甲状腺癌合并肺转移的独立危险因素(均P<0.05),年龄较大为保护因素(P<0.05)。结论儿童和青少年分化型甲状腺癌患儿中年龄较小、术后高s Tg、肿瘤直径较大、多个肿瘤病灶、甲状腺外侵犯和中央区+侧颈部淋巴结转移的患者需要警惕发生肺转移,应尽早筛查并针对性治疗。Objective To analyze the influencing factors for lung metastasis of differentiated thyroid carcinoma in children and adolescents(≤18 years old).Methods A retrospective analysis was conducted on 255 cases of differentiated thyroid carcinoma in children and adolescents treated at Zhejiang Cancer Hospital from January 2010 to October 2022.Patients were divided into observation group(n=45)and control group(n=210)based on whether lung metastasis occured.Clinical,ultrasonographic,and pathological characteristics of the two groups were compared,and univariate and multivariate logistic regression analysis was used to identify the independent influencing factors for lung metastasis.Results Patients in the observation group were younger than the control group,the proportion of patients with postoperative high stimulated thyroglobulin(sTg)and tumor diameter were larger than those of control group,and the proportion of burr structure was higher than that of control group,all with statistical significance(all P<0.05).Multivariate logistic regression analysis showed that high postoperative sTg level,large tumor diameter,multifocality of the tumor,extrathyroidal extension,and central region and lateral neck lymph node metastasis were independent risk factors for lung metastasis in children and adolescents with differentiated thyroid carcinoma(all P<0.05),while a larger age was a protective factor(P<0.05).Conclusion In children and adolescents with differentiated thyroid carcinoma,patients who are younger,have higher postoperative sTg levels,larger tumor diameters,multiple tumor foci,extrathyroidal extension,and central region and lateral neck lymph node metastasis should be vigilant for the occurrence of lung metastasis.Early screening and targeted treatment are warranted.

关 键 词：分化型甲状腺癌 儿童 青少年 肺转移 影响因素 

分 类 号：R736.1[医药卫生—肿瘤]