摘要目的 探讨未成年分化型甲状腺癌(DTC)的临床病理学特点.方法 回顾性收集2000年1月至2016年12月于北京协和医院基本外科接受治疗的手术时年龄≤18岁的107例DTC患者的临床资料.患者年龄(15.4±2.7)岁(范围:6～18岁);男性27例,女性80例.从同一时间段接受手术治疗的成人DTC患者中随机选取110例作为对照;年龄(43.2±11.8)岁(范围:21～77岁),男性35例,女性75例.比较未成年组和成人组的临床病理学特点.采用t检验、Mann-WhitneyU检验、x2检验或Fisher确切概率法对数据进行分析.结果 未成年组患者较成人组患者,肿瘤最大径更大[(16.5±9.9)mm比(8.7±5.1) mm,t=7.369,P=0.000],淋巴结转移率更高(68.2％比50.0％,x2=7.446,P=0.006),颈侧区淋巴结转移率更高(36.4％比11.8％,x2=18.059,P=0.000),肿瘤表现更为进展.未成年组原发病灶为多中心病灶时,颈侧区淋巴结转移率高于单发病灶患者(54.3％比27.8％,x2=7.144,P=0.008).成人组原发病灶合并被膜侵犯的比例高于未成年组(55.6％比19.2％,x2=28.942,P=0.000).结论 未成年DTC患者接受手术治疗时肿瘤进展程度较成人患者更高.多中心病灶的未成年DTC患者应警惕颈侧区淋巴结转移.

abstractsObjective To analyze the clinical pathology status of minor differentiated thyroid cancer (DTC).Methods The clinical pathology data of 107 cases of DTC patients aging≤18 years old who accepted operations at Department of General Surgery,Peking Union Medical College Hospital from January 2000 to December 2016 were collected.There were 27 males and 80 females,aged (15.4±2.7) years (range:6 to 18 years).And a randomly selected sample's data was collected as control group,concluded 110 adult DTC patients.There were 35 males and 75 females,aged (43.2± 11.8) years (range:21 to 77 years).The clinical and pathological data of the two groups were retrospectively analyzed.The t test,Mann-Whitney U test,x2 test and Fisher exact test was used to analyze the data,respectively.Results The minor patients had larger diameter of tumors ((16.5±9.9) mm vs.(8.7±5.1) mm,t=7.369,P=0.000),higher rate of lymph node metastasis (68.2％ vs.50.0％,x2=7.446,P=0.006) and higher rate of lateral lymph node metastasis (36.4％ vs.11.8％,x2=18.059,P=0.000) than adult patients.The rate of lateral lymph node metastasis was significantly higher when minor presented multiple fociin primary lesions (54.3％ vs.27.8％,x2=7.144,P=0.008) than those with single foci lesions.Adult patients presented more capsular invasion than minor patients in primary lesions (55.6％ vs.19.2％,x2=28.942,P=0.000).Conclusions The minor DTC patients present more progress disease status when they receive operations compared with the adult DTC patients.Minor DTC patients appeared as multiple foci should be alert to lateral lymph node metastasis.