Aim:To evaluate the presentation , clinical course and outcome of differentiated thyroid cancer ( DTC) in children.Methods:From January 2002 to December 2015, patients(age≤14 year) with DTC in Henan Tumor Hospital were identified and retrospectively reviewed .The clinical characteristics and outcome were analyzed , and the progression-free survival(PFS) and overall survival(OS) were evaluated using the Kaplan-Meier method.Results:The ratio of male to female was 1:1.7 and the median age at diagnosis was 12(6,14) year.Neck mass was the chief complaint in all patients . The most characteristic ultrasonographic feature was microcalcification .A total of 29 patients(76.3%) underwent less than total thyroidectomy and 9(23.7%) underwent total thyroidectomy .A total of 33 patients(86.2%) had neck lymph node metastasis and 6(15.8%) had lung metastasis at the time of surgery .Among the 38 patients, recurrence or metastasis oc-curred in 13 patients (34.2%).Two patients died of thyroid carcinoma and one patient died of other disease .Mean follow-up period was 88(37,156) months.The 5,10-year overall survival rate and recurrence free survival rate were 96.88%and 86.28%, 64.35%and 60.32%, respectively.Conclusion:The children with DTC had a high frequency of lymph node and distant metastasis with high reeurrence rate .the prognosis is excellent for pediatric patients , with a low mortality rate . It is recommended that pediatric thyroid cancer should be managed mostly using proper surgical approach with thyroidectomy and lymph node dissection when indicated .%目的:分析儿童分化型甲状腺癌的临床特征、治疗方法及其预后,探讨最佳治疗方法.方法:回顾性分析38例儿童甲状腺癌患者(≤14岁)的临床、影像、病理特征、治疗方法及转归,应用Kaplan-Meier进行生存分析.结果:38例儿童甲状腺癌男女性别比为1:1.7,中位年龄(四分位数)为12(6,14)岁.所有患者均以发现颈部肿块为主诉,B超发现微小钙化为儿童甲状腺癌最具特征表现.29例(76.3%)接受甲状腺次全切除术,9例(23.7%)行甲状腺全切除术.33例(86.2%)颈淋巴结转移,6例(15.8%)在手术时有肺转移.38例患者中13例(34.2%)出现术后颈部复发或转移.2例患儿死于甲状腺癌,1例死于其他疾病.中位随访时间(四分位数)为88(37,156)个月,全组5 a生存率、10 a总生存率、无复发/转移生存率分别为96.88%、86.28%,64.35%和60.32%.结论:儿童分化型甲状腺癌具有高度侵犯特征,在诊断时往往局部侵犯和颈部淋巴结或远处转移,复发率较高,但病死率低,预后良好;甲状腺全切或次全切除术联合颈清扫术是治疗的关键.
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