儿童甲状腺癌60例临床分析

目的 探讨儿童甲状腺癌的临床特点、诊断、治疗及预后。方法 回顾性分析我校三个医院1975～2002年收治并获随访的儿童甲状腺癌60例。结果 在60例儿童甲状腺癌中，乳头状腺癌49例，滤泡状腺癌8例，髓样癌3例，伴颈部淋巴结转移36例。全组患者均手术治疗，其中患侧甲状腺加峡部切除20例(33．3％)，患侧甲状腺全切加对侧甲状腺次全切36例(60％)，甲状腺全切除4例(6．7％)。术后均服甲状腺素片。平均随访10．5年(1～20年)，5年生存率为93％，10年生存率为87．1％。结论 儿童甲状腺癌多分化良好，极少发生未分化癌。重视其临床特点是早期诊治的关键，合理选择术式及术后综合治疗可取得满意疗效。

Childhood thyroid carcinoma: a clinical analysis of 60 cases

Objective To investigate clinical characteristics, diagnosis, treatment and prognosis of thyroid carcinoma in childhood. Methods Sixty patients under 14 years of age with thyroid carcinoma were retrospectively reviewed. Results Forty-nine suffered from papillary carcinoma, eight were with follicular carcinoma and three with medullary carcinoma. Cervical lymph node metastasis was found in 36 cases (60%). Operations included unilateral total thyroidectomy and isthmectomy in 20 cases (33.3%), unilateral total thyroidectomy and contralateral subtotal thyroidectomy in 36 cases (60%) and total thyroidectomy in 4 cases (6.7%). The follow-up period was 1 to 20 years (mean 10.5 years), and the survival rate of 5 and 10 years were 93% and 87.1% respectively. Conclusions Most thyroid carcinoma in children is well differentiated and the prognosis is good. A proper surgical procedure and postoperative comprehensive therapy are important for good outcome.