摘要
目的 探讨儿童甲状腺癌的临床特点、误诊原因、治疗及预后。方法 回顾性分析1977～ 1997年间收治的 14岁以下儿童甲状腺癌 14例 ,按 1989年国际抗癌联盟 (UICC)临床病理分期标准复习病理和分期。结果 乳头状癌 12例 (83.3% ) ,滤泡状癌 2例 (16 .7% )。Ⅰ期 13例 ,Ⅱ期 1例。直接误诊 7例。单侧功能性颈清扫术 11例 ,双侧颈清扫术 2例 ,姑息性甲状腺次全切除 ,术后131I治疗 1例。术后病理示颈淋巴结转移阳性者 12例 (85 .7% )。全组术后均口服甲状腺素片 ,平均随访6年 (2～ 13年 ) ,无一例死亡。结论 儿童甲状腺分化良好 ,多为乳头状癌 ,尽管颈部淋巴结转移率高 ,但预后较好。重视其临床特点结合一定的辅助检查 ,可望减少误诊 ,达到早诊早治的目的 。
Objective To reveal the clinical characteristics, causes of misdiagnosis, treatment and prognosis of thyroid carcinoma in children.Methods Fourteen patients under 14 years of age with thyroid carcinoma were retrospectively reviewed.Results According to UICC′s clinical and histopathologic classification (1989), there were 12 cases of papillary carcinomas (83.3%), 2 cases of follicular carcinomas (16.7%). All but one case were in stage Ⅰ. Cervical lymph node metastasis was found in 12 cases (85.7%). Diagnosis was incorrect in 7 cases. All patients were operated, including unilateral neck dissection in 11 and bilateral neck dissection in 2. One patient received palliative subthyroidectomy and postopevative 131 I treatment. In the follow up period of 2 to 13 years (mean 6 years), no patient died.Conclusion Thyroid cancer in children are mostly papillary carcinomas with good prognosis, regardless of high freguency of cervical lymph node metastases. Early cases can be picked up if misdiagnosis be avoided.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2000年第4期324-326,共3页
Chinese Journal of Oncology
关键词
甲状腺肿瘤
诊断
病理学
治疗
预后
儿童
Thyroid neoplasms/diagnosis
Thyroid neoplasms/pathology
Thyroid neoplasms/therapy
Prognosis
