| Objective:To study the clinicopathological characteristics of PTC in children and adolescents at different ages,analyze the related risk factors that affect the malignant degree of tumors,in order to strengthen the understanding of the disease and provide theoretical basis for clinical individualized treatment.Method:Patients who underwent thyroid surgery from January 2009 to December 2018 in the Department of Thyroid Surgery of China-Japan Union Hospital of Jilin University were selected.According to age characteristics,209 patients were screened ?20 years old.According to the inclusion and exclusion criteria,111 children and adolescents with PTC were screened from 11 to 20 years old.According to age group,11 to 14 years old were the younger age group,15 to 18 years old were the middle age group,and 19 to 20 years old were the older age group.The clinical data and pathological characteristics were retrospectively analyzed,the differences between groups at different ages were compared,and the correlation between the clinical pathological characteristics was further analyzed.Results:From January 2009 to December 2018,there were 111 cases of PTC patients aged 11 to 20 years and children and adolescents with thyroid surgery at the China-Japan Union Hospital of Jilin University,Including 14 cases in the younger age group(11-14 years old),37 cases in the middle age group(15-18 years old),60 cases in the older age group(19-20 years old).Comparing the clinical and pathological characteristics at different ages,the results showed that the three clinical and pathological characteristics of lateral neck lymph node metastasis,distant metastasis,and postoperative complications were statistically significant at different ages(P <0.05).The incidence of lateral neck lymph node metastasis was highest in the younger age group,10 cases(71.43%),followed by 20 in the middle age group(54.05%),and lowest in the older age group,17(28.33%).No distant metastasis occurred in the middle age group,and distant metastasis occurred in 2(14.29%)and 1(1.67%)of the younger and older age groups,respectively.Postoperative complications occurred in 6 cases(42.86%),4 cases(10.81%),and 3 cases(5.00%).Univariate analysis of lymph node metastasis in the level VI or VII showed that patients with tumor diameter ? 1 cm(28 cases,34.57%)were significantly less than those with tumor diameter> 1 cm(53 cases,65.43%).Further multivariate logistic regression analysis revealed that tumor diameter was correlated with level VI or VII node lymph node metastasis(OR = 0.06,95% CI: 0.02 ~ 0.21).Univariate analysis and multivariate logistic regression analysis of lateral neck lymph node metastasis showed that age(OR = 2.80,95% CI: 1.09 ~ 7.15),multiple lesions(OR = 8.15,95% CI: 3.08 ~ 21.59)and tumor Diameter> 1 cm(OR = 3.46,95% CI: 1.24 ~ 9.64)three factors are associated with the presence or absence of lymph node metastasis in the lateral neck.The single factor analysis of distant metastasis showed that among the subjects with distant metastasis,the difference between the occurrence of lateral neck metastasis and the occurrence of extrathyroidal invasion was statistically significant(P <0.05).Conclusion: 1.In PTCs of children and adolescents,patients with 11 to 14 years old had a higher proportion of lateral neck lymph node metastasis,distant metastasis and postoperative complications.2.Children and adolescents with PTC whose tumor diameter ? 1 cm are more prone to metastasis to level VI or VII 3.Children and adolescents with PTC who are ?18 years old,have multiple lesions,tumor diameter ? 1 cm,and have extrathyroidal extension are more likely to have lymph node metastasis in the lateral neck.4.Children and adolescent PTC patients with lateral neck lymph node metastasis or extrathyroidal extension have a higher probability of distant metastasis. |
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