摘要
目的:探讨青少年与成人远处转移性甲状腺乳头状癌(PTC)临床病理特征差异。方法:回顾分析2003-07-01-2012-05-01就诊于北京协和医院核医学科的879例甲状腺癌患者中,伴远处转移的PTC患者76例,分为A组(≤21岁21例)和B组(>21岁55例),对比两组临床、病理、影像学及血清学特征。结果:A组滤泡型和经典型各占44.44%,实体型11.11%。B组滤泡型43.75%,经典型34.38%,实体型18.75%,硬化型3.13%。A组肿瘤更易累及双侧腺体(P=0.002),其多灶、甲状腺外侵犯及淋巴结转移发生率分别较B组高14.15%、13.73%和6.52%,差异无统计学意义,P>0.05。131I全身显像显示,A组肺部转移灶90.48%表现为双肺弥漫性摄碘增高,B组双肺转移灶仅44.68%,呈弥漫性摄碘增高,其余则表现为局灶性摄碘增高(21.28%),甚至不摄碘(34.04%),P=0.002。首次131I治疗前促甲状腺激素(s-TSH)≤30mIU/L时,A组刺激性甲状腺球蛋白(s-Tg)平均值比B组高131.43%,当s-TSH>90mIU/L时,A组s-Tg平均值比B组低20.46%,差异无统计学意义,P>0.05。结论:青少年和成人远处转移性PTC均以滤泡亚型多见。青少年患者局部侵袭性高于成人,肺部转移灶更多表现为双肺弥漫摄碘。
OBJECTIVE： To compare the clinicopathological characteristics of papillary thyroid carcinoma （PTC） with distant metastasis between adult and young patients. METHODS：Totally 76 PTC patients with distant metastasis were enrolled in this study and grouped according to the age,group A （21 patients,age ≤21 years old） and group B （55 patients, age 〉21）. Clinicopathological, radiologica[ and hematological characteristics were analyzed between two groups. RESULTS：In group A, follicular and conventional variant accounted for 44. 44% respectively and solid variant for 11.11% ,while it was 43.75% ,34.38% and 18.75% in group B,with another 3.13% for sclerosing variant. Patients in group A presented with higher incidence of bilateral disease （P= 0. 002）. Meanwhile, prevalence of multifocality, extrathyroid invasion and lymph node metastasis were 14.15 %, 13.73 M and 6.52 %, higher in group A than those in group B. lal I whole body scanning revealed that 90.48M of patients in group A displayed diffuse ^131Ⅰ uptake in pulmonary while it was only 44.68% in group B, left other patients presented with local 131I uptake （21.28%） or none （34. 04%, P= 0. 002）. Moreover,mean value of stimulated thyroglobulin （s-Tg） was 131.43% higher in group A than that in group B when thyrotropin（s-TSH） rose to less than 30 mIU/L before initial radioactive iodine therapy. However,it was 20.46 % lower in A group when TSH exceeded 90 mlU/L, though both insignificant. CONCLUSIONS： Follicular variant is more common in PTC patients with distant metastasis both in adult and in young patients. Young PTC patients with distant metastasis usually present with more aggressive local clinieopathologieal features and diffuse ^131Ⅰ uptake in pulmonary.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第8期618-621,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
甲状腺肿瘤
成人
青少年
临床病理特征
thyroid neoplasms
adult
adolescent
clinicopathological characteristics
