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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1990年至2000年青少年甲状腺癌56例,均行手术治疗,术后行内分泌辅助治疗,少数加用131I内照射。结果全组乳头状癌44例(78.6%),滤泡状癌8例(14.3%),乳头滤泡状癌2例(3.6%),髓样癌2例(3.6%)。颈部淋巴结转移40例(71.4%),其中双侧甲状腺癌并双侧颈部淋巴结转移者8例(14.2%)。术后复发9例(16.1%)。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,5年生存率92.9%(52/56)。结论青少年甲状腺癌颈部肿块临床表现大多数无特异性,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,应引起我们的高度重视。治疗以手术为主,预后良好,疗效满意。
Objective To discuss the clinical manifestations, diagnosis, treatment and prognosis of adolescent thyroid cancer. Methods Fifty-six cases of thyroid cancer were collected from 1990 to 2000 in our hospital. All patients underwent surgical treatment. Endocrine adjuvant therapy was performed after operation. A few patients received 131I internal irradiation. Results All the patients had papillary carcinoma in 44 cases (78.6%), follicular carcinoma in 8 cases (14.3%), papillary follicular carcinoma in 2 cases (3.6%) and medullary carcinoma in 2 cases (3.6%). Forty cases (71.4%) had cervical lymph node metastasis, including 8 cases (14.2%) with bilateral thyroid carcinoma and bilateral cervical lymph node metastasis. Postoperative recurrence in 9 cases (16.1%). This group of cervical lymph node metastasis, bilateral thyroid involvement with double neck lymph node metastasis were significantly higher than adults, 5-year survival rate was 92.9% (52/56). Conclusions Most of the clinical manifestations of cervical cancer in young patients with thyroid cancer are nonspecific. Often, they are often treated with isolated lymph nodes of the neck or isolated nodules of the thyroid gland, which are not easy to be misdiagnosed as early as possible and should be highly valued by us. Surgical treatment-based, good prognosis, efficacy satisfactory.