Lin Jing,Zhao Jie.Clinicopathological features and prognoses for thyroid carcinoma in children and adolescents[J].Journal of Clinical Pediatric Surgery,,22():260-266.[doi:10.3760/cma.j.cn101785-202202019-011]
Clinicopathological features and prognoses for thyroid carcinoma in children and adolescents
- Keywords:
- Thyroid Neoplasms; Adolescent; Pathology; Prognosis
- Abstract:
- Objective To explore the clinicopathologic differences between thyroid cancer (TC) in children and adolescents versus adults and examine gene mutation,prognosis and risk factors of TC in children and adolescents.Methods For this retrospective study,84 TC children and adolescents aged ≤20 years hospitalized from June 2007 to December 2021 were included as observation group while 100 adult TC in-patients during the same period as control group.The similarities and differences of clinicopathological characteristics between two groups were compared.According to the status of gene mutation in observation group,they were divided into BRAFV600E gene mutation and wild groups.Correlation was examined between BRAFV600E mutation and clinicopathologic features of TC children and adolescents.Observation group were divided into recurrence and metastasis group and non-recurrence and metastasis group according to whether or not there was recurrence or not.And the risk factors affecting the recurrence and metastasis of TC in children and adolescents were explored by univariate and multivariate analyses.Results The number of multiple lesions(36.9% vs.22.0%),the number of bilateral lesions(34.5% vs.11.0%),pathological diagnosis(81.0% vs.31.5% for papillary thyroid carcinoma; Thyroid micropapillary carcinoma 11.9% vs.60.5%; Other 7.1% vs.0%),lymphatic metastasis(67.9% vs.42.0%)were statistically significant(P<0.05),and gender(22.6% vs.28.0%; Female 77.4% vs.72.0%),blood type(A 38.1% vs.26.0%; Type B 21.4% vs.30.0%; Type AB 35.7% vs.36.0%; Type O 4.8% vs.8.0%),type of surgery(total resection 84.5% vs.80.0%; There was no significant difference in BRAFV600E/TERT/NRAS mutation(P>0.05).In the observation group,the lymph node metastasis rate in patients with BRAFV600E gene mutation was significantly higher than that in patients without BRAFV600E gene mutation(χ2=6.497,P=0.011).Follow-up showed that 11 patients in the observation group had recurrence and metastasis after operation,while none in the control group.The recurrence and metastasis rate in the observation group was 13.1% higher than that in the control group,and the difference was statistically significant(P<0.01).The observation group was divided into recurrence and metastasis group and no recurrence and metastasis group.The results of multivariate analysis showed that age was an independent influencing factor for postoperative recurrence and metastasis(P=0.014).Follow-up to October 31,2022,84 cases in the observation group and 100 cases in the control group had no death.Conclusion The proportion of multiple lesions,bilateral lesions and lymph node metastasis is significantly higher in children and adolescents with TC than that in adults with TC.The proportion of papillary thyroid microcarcinoma is significantly lower than that in adults with TC.Lymph node metastasis rate in children and adolescents with TC with BRAFV600E mutation is significantly higher than that in wild-type patients.And age is an independent factor affecting recurrence-free survival in children and adolescents with TC.
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Memo
收稿日期:2022-2-8。
通讯作者:赵洁,Email:zjiejrxgwk@sina.com