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目的探讨儿童甲状腺癌的临床病理特点及外科治疗方法。方法回顾性分析1990年1月~2005年12月南昌大学第二附属医院手术治疗的26例儿童甲状腺癌患儿的临床病理资料、特点及治疗方法。结果女性患儿15例,稍多于男性(11例)。患儿均经病理证实为甲状腺癌,其中乳头状癌14例,滤泡状癌9例,髓样癌2例,未分化癌1例。行肿瘤剔除手术1例;一侧腺叶及峡部切除加患侧中央区淋巴结清扫术5例,加单侧颈淋巴结清扫术15例;行甲状腺全切或近全切除加双侧颈淋巴结清扫术5例。颈淋巴结转移21例(80.8%)。术后3例患儿出现暂时性有症状性甲状旁腺机能减退,经治疗后缓解;全组未出现永久性甲状旁腺功能减退、无喉返神经麻痹及手术相关性死亡。5,7年总生存率为96.2%和91.6%。结论儿童甲状腺癌多为分化型甲状腺癌,手术治疗后预后较好。
Objective To investigate the clinicopathological characteristics and surgical treatment of thyroid cancer in children. Methods The clinical data, features and treatment of 26 children with thyroid cancer underwent surgery in the Second Affiliated Hospital of Nanchang University from January 1990 to December 2005 were retrospectively analyzed. Results 15 cases of female children, slightly more than men (11 cases). Pathologically confirmed in children with thyroid cancer, including papillary carcinoma in 14 cases, follicular carcinoma in 9 cases, medullary carcinoma in 2 cases, undifferentiated carcinoma in 1 case. One case of tumor excision was performed. One case of adenomyosis and isthmus plus plus central lymphadenectomy was performed in 5 cases, plus unilateral cervical lymph node dissection in 15 cases. Thyroidectomy was performed with total or near total thyroidectomy plus bilateral cervical lymph node dissection 5 cases. Cervical lymph node metastasis in 21 cases (80.8%). Postoperative 3 patients with transient symptomatic parathyroid hypothyroidism, after treatment to alleviate; the whole group did not appear permanent hypoparathyroidism, no recurrent laryngeal nerve paralysis and surgery-related deaths. The 5-year and 7-year overall survival rates were 96.2% and 91.6%. Conclusions Most thyroid cancer in children is differentiated thyroid cancer, and the prognosis is good after surgery.