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。
Objective To explore the clinical features and treatment of thyroid carcinoma in children.Method Theclinical data of19children under14years old with thyroid carcinoma diagnosed and treated from January2003to January2014were retrospectively analyzed.Results In19cases(12males and7females),there were18cases of papillocarcinoma and onecase pf follicular carcinoma.Unilateral lobectomy plus isthmectomy was performed in6cases,subtotal thyroidectomy in4casesand total thyroidectomy in9cases.Unilateral cervical lymph node dissection was performed in5cases and bilateral in11cases.After the operation,multiple lesions were confirmed by pathology in9cases,thyroid capsular invasion in14cases,lymphaticmetastasis in15cases and distant metastasis in5cases.All the patients were treated with TSH,and10cases were treated with131Iafter operation.The median follow-up time was63months.There was no death in all cases,while local residual tumor recurrencewas found in2cases and cervical lymph node metastasis in2cases and distant metastasis in one case.Conclusion Thyroidcarcinoma in children is mostly well-differentiated,so the overall prognosis is better.However,children who have extracapsularinvasion,multiple lesions in bilateral thyroid,cervical lymph node metastasis and distant metastasis are at high risks and should betreated with comprehensive therapy that includes total thyroidectomy.
作者
王晓敏
马士崟
韩跃峰
张明洁
李慧
陈德尚
钱军
陶新全
WANG Xiaomin;MA Shiyin;HAN Yuefeng;ZHANG Mingjie;LI Hui;CHEN Deshang;QIAN jun;TAO Xinquan(Department of Otorhinolaryngology,The First Affiliated Hospital, Bengbu Medical College, Bengbu 233004, Anhui, China;Department of Oncological Surgery,The First Affiliated Hospital, Bengbu Medical College, Bengbu 233004, Anhui, China;Department of Nuclear Medicine, The First Affiliated Hospital, Bengbu Medical College, Bengbu 233004, Anhui, China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2017年第4期282-285,共4页
Journal of Clinical Pediatrics
关键词
甲状腺癌
治疗
儿童
thyroid carcinoma
treatment
child
