临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (4): 282-.doi: 10.3969/j.issn.1000-3606.2017.04.010

• 综合报道 • 上一篇    下一篇

儿童甲状腺癌的临床特点及治疗分析

王晓敏1, 马士崟1, 韩跃峰1, 张明洁1, 李慧1, 陈德尚1, 钱军2, 陶新全3   

  1. 蚌埠医学院第一附属医院1 . 耳鼻喉头颈外科,2 . 肿瘤外科,3 . 核医学科(安徽蚌埠 233004)
  • 收稿日期:2017-04-15 出版日期:2017-04-15 发布日期:2017-04-15
  • 通讯作者: 马士崟 E-mail:mashiyinent@sina.com

Clinical features and treatment of thyroid carcinoma in children

 WANG Xiaomin1, MA Shiyin1, HAN Yuefeng1, ZHANG Mingjie1, LI Hui1, CHEN Deshang1, QIAN jun2, TAO Xinquan2   

  1. 1. Department of Otorhinolaryngology, 2. Department of Oncological Surgery, 3. Department of Nuclear Medicine, The First Affiliated Hospital, Bengbu Medical College, Bengbu 233004, Anhui, China
  • Received:2017-04-15 Online:2017-04-15 Published:2017-04-15

摘要: 目的 探讨儿童甲状腺癌的临床特点及治疗方法。方法 回顾分析2003年1月至2014年1月诊断和治疗的19 例14岁以下甲状腺癌患儿的临床资料。结果 19例患儿中,男12例,女7例;乳头状癌18例,滤泡状癌1例。行甲状腺峡 部加一侧腺叶切除术6例,甲状腺次全切除术4例,甲状腺全切除术9例;单侧颈淋巴结清扫5例、双侧11 例。术后病理证 实多灶者9例,包膜受侵者14例,淋巴结转移者15例,远处转移5例。所有患儿术后均行促甲状腺激素抑制, 10例行131I治疗。 中位随访时间63个月,无死亡病例; 2例局部残叶肿瘤复发, 2例出现颈部淋巴结转移, 1例出现远处转移。结论 儿童甲 状腺癌多为分化型甲状腺癌,总体预后较好,但包膜外侵、两叶多灶、颈部淋巴结及远处转移的高风险患儿需选择甲状腺 全切为主的综合治疗方案。

Abstract:  Objective To explore the clinical features and treatment of thyroid carcinoma in children. Method The clinical data of 19 children under 14 years old with thyroid carcinoma diagnosed and treated from January 2003 to January 2014 were retrospectively analyzed. Results In 19 cases (12 males and 7 females), there were 18 cases of papillocarcinoma and one case pf follicular carcinoma. Unilateral lobectomy plus isthmectomy was performed in 6 cases, subtotal thyroidectomy in 4 cases and total thyroidectomy in 9 cases. Unilateral cervical lymph node dissection was performed in 5 cases and bilateral in 11 cases. After the operation, multiple lesions were confirmed by pathology in 9 cases, thyroid capsular invasion in 14 cases, lymphatic metastasis in 15 cases and distant metastasis in 5 cases. All the patients were treated with TSH, and 10 cases were treated with 131I after operation. The median follow-up time was 63 months. There was no death in all cases, while local residual tumor recurrence was found in 2 cases and cervical lymph node metastasis in 2 cases and distant metastasis in one case. Conclusion Thyroid carcinoma in children is mostly well-differentiated, so the overall prognosis is better. However, children who have extracapsular invasion, multiple lesions in bilateral thyroid, cervical lymph node metastasis and distant metastasis are at high risks and should be treated with comprehensive therapy that includes total thyroidectomy.