| ObjectiveIn order to guide clinical treatment,we investigate the clinical pathological characteristics of papillary thyroid carcinoma in adults,children and adolescents,To further analyze the characteristics and risk factors of thyroid papillary carcinoma in children and adolescents.MethodsA retrospective records from February 2011 to February 2017 in the thyroid surgery of the First Affiliated Hospital of Zhengzhou University,the first surgical treatment and confirmed by pathology after surgery for papillary thyroid carcinoma,the age of onset is less than or equal to 18 year old children and adolescents with the clinical data of 135 copies were studied.At the same time,the data of 120 cases of thyroid papillary carcinoma in our hospital were analyzed.The pathological results of the patients who were older than the age of onset were treated by surgery.We researched clinical and pathological differences between adults and children and adolescents,analyzed the clinical features and risk factors of cervical lymph node metastasis and lung metastasis in children and adolescents.Results135 children and adolescents aged from 3 to 18 years,with a median age of 16 years.There were 33 male patients and female patients with a total of 102 cases.The maximum tumor diameter was 7.5cm,the minimum diameter was 0.3cm,and the tumor diameter median was 1.7cm.Tumor lesions were solitary in 96 cases and multiple lesions in tumor were 39 cases.31 cases of tumor complicated with Hashimoto,and the tumor was not associated with Hashimoto were 104 cases.There were 31 cases of tumor invasion and no tumor invasion of the membrane were 104 cases.There were 97 cases of cervical lymph node metastasis,and the median of metastatic lymph nodes was 4,and there was no cervical lymph node metastasis were 38 cases.There were 17 cases with lung metastasis,and no lung metastasis in 118 cases.There were 28 cases of recurrence after treatment,no recurrence after treatment in 107 cases.120 adult patients ranged in age from 23 to 74 years with a median age of 45 years.There were 26 male patients and female patients with a total of 94 cases.The maximum tumor diameter was 6cm,the smallest tumor diameter was 0.1cm,and the tumor diameter median was 0.9cm.Tumor lesions were solitary in 85 cases and multiple lesions in tumor in 35 cases.The tumor was complicated with Hashimoto in 13 cases,and the tumor was not combined with Hashimoto's disease in 107 cases.There were 16 cases of tumor invasion and no tumor invasion of the membrane in 104 cases.There were 42 cases of cervical lymph node metastasis,and the median of metastatic lymph nodes was 0,and there was no cervical lymph node metastasis in 78 cases.There were 4 cases with lung metastasis,and no lung metastasis in 116 cases.There were 8 cases of recurrence after treatment,no recurrence after treatment in 112 cases.Statistical analysis showed that: compared with adult thyroid papillary carcinoma in children and adolescents,tumor diameter(Z=-5.416),the number of lymph node metastasis(Z=-6.722),and Hashimoto(?2=6.547),capsule invasion(?2=3.918),lung metastasis(?2=7.207),recurrence(?2=-10.379)a significant difference.Spearman rank correlation analysis showed that the size of thyroid papillary carcinoma in children and adolescents was related to the number of cervical lymph node metastasis,and the correlation coefficient(r=0.221).Logistic regression analysis showed that the tumor size is a risk factor for metastasis of papillary thyroid carcinoma cervical lymph nodes in children and adolescents(OR=63.572),capsule invasion,number of lesions are risk factors of children and adolescents with papillary thyroid carcinoma lung metastasis(OR = 6.598,10.933).ConclusionCompared with adults,Papillary thyroid carcinoma in children and adolescents have the larger the size of the tumor,and the cervical lymph node metastasis is more serious,the tumor with Hashimoto,the film was invaded,lung metastasis,recurrence rate is higher.The incidence of cervical lymph node metastasis in children and adolescents with tumor diameter greater than 1cm is relatively high,and the larger the tumor diameter,the more the number of cervical lymph node metastasis.The incidence of lung metastasis was significantly increased in children and adolescents with papillary thyroid carcinoma who had multiple lesions and capsule infringement. |
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