Clinicopathological characteristics and prognosis of papillary thyroid cancer in adolescents_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Yuxiao ¹ , LIU Weihao ¹ , ZHANG Yifei ¹ , LI Hongqiang ¹ , TANG Yifeng ¹ ,  YIN Detao ^1,2,3

1. Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China;
2. Engineering Research Center of Multidisciplinary Diagnosis and Treatment of Thyroid Cancer of Henan Province, Zhengzhou 450052, P. R. China;
3. Key Medicine Laboratory of Thyroid Cancer of Henan Province, Zhengzhou 450052, P. R. China;

Corresponding author：

YIN Detao, Email: detaoyin@zzu.edu.cn

Keywords：

papillary thyroid cancer; adolescent; lateral lymph node metastasis; recurrence

DOI：

10.7507/1007-9424.202403033

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the clinicopathological characteristics of papillary thyroid cancer (PTC) in adolescents and analyze the risk factors affecting lateral lymph node metastasis and prognosis. Methods In retrospectively, 150 adolescent PTC patients admitted to the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2022 and meeting the inclusion and exclusion criterias were collected as the study subjects (adolescent group), and 100 adult PTC patients were selected as adult group. Statistical analysis was performed with SPSS 25.0 software to compare the clinicopathological characteristics of the patients in the two groups, and to explore the risk factors for lateral lymph node metastasis and recurrence in adolescent PTC patients by using logistic regression and Cox proportional hazards regression models, respectively. Results Adolescents with PTC were more prone to extrandular invasion [30.0% (45/150) versus 17.0% (17/100), P=0.020], neck lymph node metastasis [79.3% (119/150) versus 48.0% (48/100), P<0.001], central lymph node metastasis [78.7% (118/150) versus 48.0% (48/100), P<0.001], lateral lymph node metastasis [44.0% (66/150) versus 12.0% (12/100), P<0.001]; and had a greater maximum tumor diameter (1.75 cm versus 0.75 cm, P＜0.001) and higher ratio of greater maximum tumor diameter ＞2 cm [45.3% (68/150) versus 8.0% (8/100), P＜0.001] in adolescent PTC patients. In adolescent PTC patients, extraglandular invasion (OR=2.654, P=0.022), multifoci (OR=4.860, P<0.001) and maximum tumor diameter>2 cm (OR=3.845, P=0.001) were risk factors for lateral lymph node metastasis; lateral lymph node metastasis (RR=10.105, P=0.040) and distant metastasis (RR=7.058, P=0.003) were predictors of postoperative recurrence in adolescent PTC patients. Conclusions Compared with adult PTC patients, adolescent PTC patients have more aggressive tumors. Adolescent PTC with extraglandular invasion, multilesions, and maximum tumor diameter>2 cm should be considered for lateral lymph node dissection; and adolescent PTC patients with lateral lymph node metastasis and distant metastasis should pay close attention to their recurrence status.

Citation： SUN Yuxiao, LIU Weihao, ZHANG Yifei, LI Hongqiang, TANG Yifeng, YIN Detao. Clinicopathological characteristics and prognosis of papillary thyroid cancer in adolescents. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(11): 1330-1335. doi: 10.7507/1007-9424.202403033 Copy

1.	常靖涛, 王崴然, 贾宝凇, 等. cN0多灶甲状腺微小乳头状癌与中央区淋巴结转移关系的研究进展. 中国普外基础与临床杂志, 2022, 29(3): 382-388.
2.	王志宏, 张浩. 儿童及青少年分化型甲状腺癌外科治疗策略. 中国实用外科杂志, 2022, 42(6): 648-652.
3.	Management Guidelines for children with thyroid nodules and differentiated thyroid cancer. Pediatrics, 2018, 142(6): e20183063. doi: 10.1542/peds.2018-3063.
4.	张桂萍, 詹维伟. 儿童及青少年甲状腺癌超声诊断. 中国实用外科杂志, 2022, 42(6): 643-648.
5.	田文, 万政. 重视儿童及青少年甲状腺癌的规范化诊治. 中国实用外科杂志, 2022, 42(6): 621-624, 666.
6.	de Jong MC, Gaze MN, Szychot E, et al. Treating papillary and follicular thyroid cancer in children and young people: single UK-center experience between 2003 and 2018. J Pediatr Surg, 2021, 56(3): 534-539.
7.	杨崚怡, 郭凯, 钱凯, 等. 儿童及青少年甲状腺癌分子生物学研究进展. 中国实用外科杂志, 2022, 42(6): 716-720.
8.	倪鑫, 王生才, 刘雨薇. 《儿童甲状腺癌诊疗规范 (2021年版)》解读. 中国实用外科杂志, 2022, 42(6): 625-628.
9.	中国临床肿瘤学会核医学专家委员会, 中国临床肿瘤学会甲状腺癌专家委员会, 中国医疗保健国际交流促进会甲状腺疾病专业委员会, 等. 儿童及青少年分化型甲状腺癌核医学诊治中国专家共识 (2022年版). 中国癌症杂志, 2022, 32(5): 451-468.
10.	Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
11.	陈怡如, 雷亚丽, 邹联洪, 等. 儿童及青少年甲状腺癌的临床特征与预后分析. 中国普通外科杂志, 2022, 31(5): 608-618.
12.	高洪波, 马淋淋, 邰隽, 等. 儿童及青少年分化型甲状腺癌的临床病理特征分析. 中国耳鼻咽喉头颈外科, 2016, 23(7): 371-373.
13.	Alzahrani AS, Alkhafaji D, Tuli M, et al. Comparison of differentiated thyroid cancer in children and adolescents (≤20 years) with young adults. Clin Endocrinol (Oxf), 2016, 84(4): 571-577.
14.	Lebbink CA, Links TP, Czarniecka A, et al. 2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma. Eur Thyroid J, 2022, 11(6): e220146.
15.	Lazar L, Lebenthal Y, Steinmetz A, et al. Differentiated thyroid carcinoma in pediatric patients: comparison of presentation and course between pre-pubertal children and adolescents. J Pediatr, 2009, 154(5): 708-714.
16.	Guo K, Qian K, Shi Y, et al. Clinical and molecular characterizations of papillary thyroid cancer in children and young adults: a multicenter retrospective study. Thyroid, 2021, 31(11): 1693-1706.
17.	Olmsted C, Arunachalam R, Gao X, et al. Pediatric differentiated thyroid carcinoma: trends in practice and outcomes over 40 years at a single tertiary care institution. J Pediatr Endocrinol Metab, 2017, 30(10): 1067-1074.
18.	赵文新, 王波, 翁煜景, 等. 儿童及青少年甲状腺癌淋巴结转移特点及治疗策略. 中国实用外科杂志, 2017, 37(9): 973-977, 997.
19.	Russo M, Malandrino P, Moleti M, et al. Differentiated thyroid cancer in children: heterogeneity of predictive risk factors. Pediatr Blood Cancer, 2018, 65(9): e27226. doi: 10.1002/pbc.27226.
20.	Ito Y, Fukushima M, Higashiyama T, et al. Tumor size is the strongest predictor of microscopic lymph node metastasis and lymph node recurrence of N0 papillary thyroid carcinoma. Endocr J, 2013, 60(1): 113-117.
21.	毛晓春, 叶柳青, 项洋锋, 等. 儿童及青少年甲状腺乳头状癌颈侧区淋巴结转移风险预测模型研究. 中国耳鼻咽喉头颈外科, 2022, 29(5): 278-282.
22.	Liang W, Sheng L, Zhou L, et al. Risk factors and prediction model for lateral lymph node metastasis of papillary thyroid carcinoma in children and adolescents. Cancer Manag Res, 2021, 13: 1551-1558.
23.	Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 2016, 26(1): 1-133.
24.	田文, 李晨, 姚京. 关于甲状腺癌术后复发几点思考. 中国实用外科杂志, 2021, 41(8): 849-852.
25.	Zanella AB, Scheffel RS, Weinert L, et al. New insights into the management of differentiated thyroid carcinoma in children and adolescents (review). Int J Oncol, 2021, 58(5): 13. doi: 10.3892/ijo.2021.5193.
26.	Klein Hesselink MS, Nies M, Bocca G, et al. Pediatric differentiated thyroid carcinoma in the Netherlands: a nationwide follow-up study. J Clin Endocrinol Metab, 2016, 101(5): 2031-2039.

1. 常靖涛, 王崴然, 贾宝凇, 等. cN0多灶甲状腺微小乳头状癌与中央区淋巴结转移关系的研究进展. 中国普外基础与临床杂志, 2022, 29(3): 382-388.
2. 王志宏, 张浩. 儿童及青少年分化型甲状腺癌外科治疗策略. 中国实用外科杂志, 2022, 42(6): 648-652.
3. Management Guidelines for children with thyroid nodules and differentiated thyroid cancer. Pediatrics, 2018, 142(6): e20183063. doi: 10.1542/peds.2018-3063.
4. 张桂萍, 詹维伟. 儿童及青少年甲状腺癌超声诊断. 中国实用外科杂志, 2022, 42(6): 643-648.
5. 田文, 万政. 重视儿童及青少年甲状腺癌的规范化诊治. 中国实用外科杂志, 2022, 42(6): 621-624, 666.
6. de Jong MC, Gaze MN, Szychot E, et al. Treating papillary and follicular thyroid cancer in children and young people: single UK-center experience between 2003 and 2018. J Pediatr Surg, 2021, 56(3): 534-539.
7. 杨崚怡, 郭凯, 钱凯, 等. 儿童及青少年甲状腺癌分子生物学研究进展. 中国实用外科杂志, 2022, 42(6): 716-720.
8. 倪鑫, 王生才, 刘雨薇. 《儿童甲状腺癌诊疗规范 (2021年版)》解读. 中国实用外科杂志, 2022, 42(6): 625-628.
9. 中国临床肿瘤学会核医学专家委员会, 中国临床肿瘤学会甲状腺癌专家委员会, 中国医疗保健国际交流促进会甲状腺疾病专业委员会, 等. 儿童及青少年分化型甲状腺癌核医学诊治中国专家共识 (2022年版). 中国癌症杂志, 2022, 32(5): 451-468.
10. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
11. 陈怡如, 雷亚丽, 邹联洪, 等. 儿童及青少年甲状腺癌的临床特征与预后分析. 中国普通外科杂志, 2022, 31(5): 608-618.
12. 高洪波, 马淋淋, 邰隽, 等. 儿童及青少年分化型甲状腺癌的临床病理特征分析. 中国耳鼻咽喉头颈外科, 2016, 23(7): 371-373.
13. Alzahrani AS, Alkhafaji D, Tuli M, et al. Comparison of differentiated thyroid cancer in children and adolescents (≤20 years) with young adults. Clin Endocrinol (Oxf), 2016, 84(4): 571-577.
14. Lebbink CA, Links TP, Czarniecka A, et al. 2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma. Eur Thyroid J, 2022, 11(6): e220146.
15. Lazar L, Lebenthal Y, Steinmetz A, et al. Differentiated thyroid carcinoma in pediatric patients: comparison of presentation and course between pre-pubertal children and adolescents. J Pediatr, 2009, 154(5): 708-714.
16. Guo K, Qian K, Shi Y, et al. Clinical and molecular characterizations of papillary thyroid cancer in children and young adults: a multicenter retrospective study. Thyroid, 2021, 31(11): 1693-1706.
17. Olmsted C, Arunachalam R, Gao X, et al. Pediatric differentiated thyroid carcinoma: trends in practice and outcomes over 40 years at a single tertiary care institution. J Pediatr Endocrinol Metab, 2017, 30(10): 1067-1074.
18. 赵文新, 王波, 翁煜景, 等. 儿童及青少年甲状腺癌淋巴结转移特点及治疗策略. 中国实用外科杂志, 2017, 37(9): 973-977, 997.
19. Russo M, Malandrino P, Moleti M, et al. Differentiated thyroid cancer in children: heterogeneity of predictive risk factors. Pediatr Blood Cancer, 2018, 65(9): e27226. doi: 10.1002/pbc.27226.
20. Ito Y, Fukushima M, Higashiyama T, et al. Tumor size is the strongest predictor of microscopic lymph node metastasis and lymph node recurrence of N0 papillary thyroid carcinoma. Endocr J, 2013, 60(1): 113-117.
21. 毛晓春, 叶柳青, 项洋锋, 等. 儿童及青少年甲状腺乳头状癌颈侧区淋巴结转移风险预测模型研究. 中国耳鼻咽喉头颈外科, 2022, 29(5): 278-282.
22. Liang W, Sheng L, Zhou L, et al. Risk factors and prediction model for lateral lymph node metastasis of papillary thyroid carcinoma in children and adolescents. Cancer Manag Res, 2021, 13: 1551-1558.
23. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 2016, 26(1): 1-133.
24. 田文, 李晨, 姚京. 关于甲状腺癌术后复发几点思考. 中国实用外科杂志, 2021, 41(8): 849-852.
25. Zanella AB, Scheffel RS, Weinert L, et al. New insights into the management of differentiated thyroid carcinoma in children and adolescents (review). Int J Oncol, 2021, 58(5): 13. doi: 10.3892/ijo.2021.5193.
26. Klein Hesselink MS, Nies M, Bocca G, et al. Pediatric differentiated thyroid carcinoma in the Netherlands: a nationwide follow-up study. J Clin Endocrinol Metab, 2016, 101(5): 2031-2039.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinicopathological characteristics and prognosis of papillary thyroid cancer in adolescents

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content