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首页> 外文期刊>Indian Journal of Pediatrics >Differentiated thyroid cancer
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Differentiated thyroid cancer

机译：分化型甲状腺癌

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Objective: The retrospective analysis of the case files of children with differentiated thyroid carcinoma (DTC) was performed to define the disease by its presentation, clinical course and outcome of radioiodine therapy.Methods: Between 1967 to October 2002,1754 patients with thyroid cancer were treated in the Dept of Neuclear Medicine, AIIMS, out of which 122 (7%) were ≶ 20 years of age (71 girls and 51 boys). The mean age was 15.8 ± 3.6 years and the mean duration of follow-up was 90 ± 59.3 months. Mean tumor size was 4.4 cm. Histologically, 85% of the patients had papillary and rest follicular carcinoma. Cervical lymph node involvement was seen in 64%, and distant metastases, mainly pulmonary, in 23% of the patients. The presentation of the disease was very aggressive in the first decade of life with male preponderance. All but one patient in this age group had nodal and/or distant metastases; in 83.3% the disease had spread to the lymph nodes and 67% had metastases to the lungs. The post-surgery 48-hour mean radioiodine neck uptake was 10.5 ± 7.6%.Results: 94% of the residual thyroid, 88% of nodal metastases and 71% of pulmonary metastases were ablated requiring mean cumulative doses of 2.8 ± 2.7 GBq, 4.5 ± 2.7 GBq and 10.4 ± 7.9 GBq of131I, respectively. Average number of doses required for remnant, nodal and pulmonary metastases ablation were 1.3, 2.2 and 3.3, respectively. 80% of the patients with only remnant thyroid tissue and 50% with cervical lymph node metastases got ablated with a single dose of131I. Overall, 87% patients were currently free of disease. While, nine patients had nodal recurrence between surgery and radioiodine treatment, no recurrence was observed thereafter and 3 disease related deaths producing overall mortality of 2.5% (all in children ≶10 years of age) were seen in the mean follow-up of 7.5 years.Conclusion: Differentiated thyroid cancer in children and adolescents is rare but aggressive. The biological behavior differs from that in adults and is related to the age. Younger the age (≶10 years), more aggressive and widespread is the disease with male preponderance and high mortality. The Post-surgical radioiodine ablation/therapy is an important and effective adjuvant in the management of DTC in children and adolescents and even though they present with advance disease, long-term survival and overall prognosis is good. Keywords Childhood thyroid cancer - Radioiodine ablation
机译：目的：对分化型甲状腺癌（DTC）患儿的病历进行回顾性分析，根据其表现，临床过程和放射碘疗法的结果对疾病进行分类。方法：1967年至2002年10月，共收治1754例甲状腺癌患者。在AIIMS的神经系统医学部门接受治疗的患者中，有122（7％）岁不到20岁（71名女孩和51名男孩）。平均年龄为15.8±3.6岁，平均随访时间为90±59.3个月。平均肿瘤大小为4.4cm。在组织学上，85％的患者患有乳头状癌和休息性滤泡癌。 64％的患者发现宫颈淋巴结受累，23％的患者发生远处转移，主要是肺转移。在男性占优势的生命的头十年中，这种疾病的表现非常激进。在这一年龄段，除一名患者外，所有患者均出现淋巴结转移和/或远处转移。在83.3％的患者中，该病已扩散到淋巴结，而67％的患者已转移到了肺。手术后48小时平均放射性碘摄入量为10.5±7.6％。结果：消融了94％的残留甲状腺，88％的淋巴结转移和71％的肺转移，平均累积剂量为2.8±2.7 GBq，4.5 131 I分别为±2.7 GBq和10.4±7.9 GBq。残余，淋巴结转移和肺转移消融所需的平均剂量分别为1.3、2.2和3.3。单剂量的 131 I可消融仅残留甲状腺组织的患者中的80％，且颈部淋巴结转移的患者中的50％。总体而言，目前有87％的患者没有疾病。虽然有9名患者在手术和放射性碘治疗之间出现淋巴结复发，但此后未见复发，在平均7.5年的随访中，发现3例疾病相关的死亡导致总死亡率为2.5％（全部发生在10岁以下的儿童中）。结论：儿童和青少年的分化型甲状腺癌很少见但具有侵袭性。生物学行为不同于成年人，并且与年龄有关。该病以男性占优势，死亡率高，年龄较小（10岁左右），更具侵略性和广泛性。手术后放射性碘的消融/治疗是控制儿童和青少年DTC的重要而有效的辅助手段，即使他们患有疾病，长期生存和总体预后也很好。关键词儿童甲状腺癌-放射性碘消融

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