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目的:探讨儿童及青少年甲状腺癌的临床和病理特征,分析乳头状癌组淋巴结转移的风险因素。方法:回顾性分析2003年1月至2013年12月间本院收治的儿童及青少年甲状腺癌病例资料,了解临床特征和病理特点及分析乳头状癌亚组淋巴结转移的风险因素。结果:共收集51例儿童及青少年甲状腺癌资料,49例甲状腺乳头状癌,2例甲状腺髓样癌。乳头状癌亚组淋巴结转移率达77.5%,患儿年龄与淋巴结转移相关,Logistic回归提示年龄是颈部淋巴结转移的独立风险因素(OR=1.40;95%CL=1.05,1.85;P=0.021)。随访中5例出现局部复发。结论:儿童及青少年甲状腺癌有区别于成人甲状腺癌的特殊性,积极筛查儿童甲状腺疾病、全面彻底的外科手术和制定相应的风险评估标准、积极随访是治疗该病的关键。
Objective: To investigate the clinical and pathological features of thyroid cancer in children and adolescents and to analyze the risk factors of lymph node metastasis in papillary carcinoma. Methods: The data of thyroid cancer in children and adolescents admitted from January 2003 to December 2013 in our hospital were retrospectively analyzed. The clinical and pathological features were analyzed and the risk factors of lymph node metastasis in the subgroup of papillary carcinoma were analyzed. Results: A total of 51 cases of thyroid cancer in children and adolescents were collected, 49 cases of thyroid papillary carcinoma and 2 cases of medullary thyroid carcinoma. The lymph node metastasis rate was 77.5% in the subgroup of papillary carcinoma. Logistic regression analysis indicated that age was an independent risk factor for cervical lymph node metastasis (OR = 1.40; 95% CL = 1.05, 1.85; P = 0.021) . Follow-up in 5 cases of local recurrence. Conclusion: Children and adolescents with thyroid cancer are different from the specificity of adult thyroid cancer, aggressive screening of children with thyroid disease, thorough surgery and the development of appropriate risk assessment criteria, and follow-up is the key to the treatment of the disease.