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目的讨论青少年甲状腺癌的临床表现、诊断、治疗及预后。方法收集我院2005年1月1日～2012年12月31日20岁以下青少年甲状腺癌59例,均行手术治疗,术后行内分泌辅助治疗,14例联合131I内照射治疗。结果本组乳头状癌56例(94.9%)其中微小乳头状癌29例;滤泡状腺癌1例(1.7%);髓样癌2例(3.4%)。颈淋巴结转移34例(57.6%),其中双侧甲状腺癌并双侧颈部淋巴结转移者7例(11.9%)。术后5年内复发1例(1.7%)。本组颈部淋巴结转移率、双侧甲状腺受侵犯伴双颈淋巴结转移率均明显高于成年人。结论青少年甲状腺癌早起临床表现大多数不典型,常以颈部肿大淋巴结或甲状腺孤立结节就诊,不易早发现易误诊。治疗以手术为主,预后良好。
Objective To discuss the clinical manifestations, diagnosis, treatment and prognosis of adolescent thyroid cancer. Methods A total of 59 adolescents with thyroid cancer under 20 years of age from January 1, 2005 to December 31, 2012 were enrolled in this study. All patients underwent surgical treatment. Endocrine adjuvant therapy was performed after operation, and 14 cases were treated with 131I internal irradiation. Results There were 56 cases of papillary carcinoma (94.9%) in this group, including 29 cases of tiny papillary carcinoma, 1 case of follicular adenocarcinoma (1.7%) and 2 cases of medullary carcinoma (3.4%). There were 34 cases (57.6%) of cervical lymph node metastasis, including 7 cases (11.9%) with bilateral thyroid carcinoma and bilateral cervical lymph node metastasis. One case (1.7%) relapsed within 5 years after operation. This group of cervical lymph node metastasis, bilateral thyroid invasion with double neck lymph node metastasis were significantly higher than adults. Conclusion Most of the clinical manifestations of early thyroid cancer in adolescents are not typical, often with enlarged neck lymph nodes or isolated thyroid nodules, easy to find early misdiagnosis. The main treatment is surgery, the prognosis is good.