儿童甲状腺癌的临床特点及治疗分析

发布时间：2018-06-19 09:49

本文选题：甲状腺癌 + 治疗　；参考：《临床儿科杂志》2017年04期

【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 investigate the clinical features and treatment of thyroid carcinoma in children. Methods the clinical data of 19 children with thyroid cancer under 14 years old diagnosed and treated from January 2003 to January 2014 were retrospectively analyzed. Results among 19 children, 12 were male, 7 were female, 18 were papillary carcinoma and 1 was follicular carcinoma. Thyroid isthmus plus unilateral lobectomy was performed in 6 cases, subtotal thyroidectomy in 4 cases, total thyroidectomy in 9 cases, unilateral neck lymph node dissection in 5 cases and bilateral dissection in 11 cases. Pathologically, 9 cases had multiple foci, 14 cases had capsule invasion, 15 cases had lymph node metastasis and 5 cases had distant metastasis. All the children were treated with 131 I after operation. The median follow-up time was 63 months. There were 2 cases of local residual lobe tumor recurrence and 2 cases of cervical lymph node metastasis in 2 cases without death. 1 case had distant metastasis. Conclusion thyroid carcinoma in children is mostly differentiated thyroid carcinoma and the overall prognosis is good. However, the high risk children with extracapsular invasion, multiple foci of two lobes, cervical lymph nodes and distant metastasis need to choose the comprehensive treatment of total thyroidectomy.
【作者单位】：蚌埠医学院第一附属医院耳鼻喉头颈外科;蚌埠医学院第一附属医院肿瘤外科;蚌埠医学院第一附属医院核医学科;
【分类号】：R736.1

【参考文献】