1.广东省人民医院·广东省医学科学院内分泌科,广州 510080
2.中国医科大学附属第一医院内分泌科,沈阳 110001
Received:13 October 2022,
Published:28 November 2022
移动端阅览
王龙,付金蓉,邝建.儿童和青少年甲状腺癌临床管理的研究进展[J].重庆医科大学学报,2022,47(11):1268-1272.
Wang Long,Fu Jinrong,Kuang Jian.Advances in clinical management of thyroid cancer in children and adolescents[J].Journal of Chongqing Medical University,2022,47(11):1268-1272.
王龙,付金蓉,邝建.儿童和青少年甲状腺癌临床管理的研究进展[J].重庆医科大学学报,2022,47(11):1268-1272. DOI: 10.13406/j.cnki.cyxb.003123.
Wang Long,Fu Jinrong,Kuang Jian.Advances in clinical management of thyroid cancer in children and adolescents[J].Journal of Chongqing Medical University,2022,47(11):1268-1272. DOI: 10.13406/j.cnki.cyxb.003123.
儿童和青少年甲状腺癌(简称“儿童甲状腺癌”)一般指发生在18岁以下个体中的甲状腺恶性肿瘤。尽管发病率不高,但随着近年来甲状腺癌整体患病率上升,儿童甲状腺癌患者的数量也呈增加趋势。目前对儿童甲状腺癌的诊疗方案多参照成人。但是,儿童甲状腺癌在临床病理特征、分子改变和预后等方面与成人甲状腺癌存在差异,对此认识不充分可能会造成治疗不足或过度治疗,进而对儿童生理、心理和社会能力的发展产生不良影响。因此,应当积极倡导对儿童甲状腺癌规范化诊治的研究和普及。本文结合近年来关于儿童甲状腺癌的临床研究和管理指南/共识,对儿童甲状腺癌的流行病学、临床特点、管理策略和现存问题进行综述。
Thyroid cancer in children and adolescents(referred to as “pediatric thyroid cancer”) generally refers to thyroid malignant tumors occurred in subjects younger than 18 years of age. Although thyroid cancer is less common in childhood and adolescence, the incidence of pediatric thyroid cancer has been rising with the global increase of thyroid cancer in recent years. Although the clinical and pathological characteristics,and prognosis of pediatric thyroid cancer are different from those of adult patients,the current clinical management for pediatric thyroid cancer is mostly based on strategies for adult patients. Insufficient understanding of pediatric thyroid cancer can lead to undertreatment or overtreatment,which leads to negative impacts on the development of physiological,psychological and social ability in children. Therefore,it is of great significance to develop a standardized diagnosis and treatment schemes for pediatric thyroid cancer. Here we review epidemiology,clinical characteristics,management strategies,and present challenges of pediatric thyroid cancer based on the clinical studies and guidelines or consensus for pediatric thyroid cancer.
Paulson VA , Rudzinski ER , Hawkins DS . Thyroid cancer in the pediatric population [J ] . Genes , 2019 , 10 ( 9 ): 723 .
Kuo AH , Nuñez DB . Giant pituitary adenoma with inferior petrosal sinus,jugular foramen,and hypoglossal canal extension [J ] . JAMA Otolaryngol Head Neck Surg , 2020 , 146 ( 1 ): 82 - 84 .
Vaccarella S , Lortet-Tieulent J , Colombet M , et al . Global patterns and trends in incidence and mortality of thyroid cancer in children and adolescents:a population-based study [J ] . Lancet Diabetes Endocrinol , 2021 , 9 ( 3 ): 144 - 152 .
Bernier MO , Withrow DR , Berrington de Gonzalez A , et al . Trends in pediatric thyroid cancer incidence in the United States,1998-2013 [J ] . Cancer , 2019 , 125 ( 14 ): 2497 - 2505 .
Qian ZJ , Jin MC , Meister KD , et al . Pediatric thyroid cancer incidence and mortality trends in the United States,1973-2013 [J ] . JAMA Otolaryngol Head Neck Surg , 2019 , 145 ( 7 ): 617 - 623 .
Williams D . Thyroid growth and cancer [J ] . Eur Thyroid J , 2015 , 4 ( 3 ): 164 - 173 .
Hanley P , Lord K , Bauer AJ . Thyroid disorders in children and adolescents:a review [J ] . JAMA Pediatr , 2016 , 170 ( 10 ): 1008 - 1019 .
Ito M , Yamashita S , Ashizawa K , et al . Childhood thyroid diseases around chernobyl evaluated by ultrasound examination and fine needle aspiration cytology [J ] . Thyroid , 1995 , 5 ( 5 ): 365 - 368 .
Cahoon EK , Nadyrov EA , Polyanskaya ON , et al . Risk of thyroid nodules in residents of belarus exposed to chernobyl fallout as children and adolescents [J ] . J Clin Endocrinol Metab , 2017 , 102 ( 7 ): 2207 - 2217 .
Chan CM , Young J , Prager J , et al . Pediatric thyroid cancer [J ] . Adv Pediatr , 2017 , 64 ( 1 ): 171 - 190 .
Christison-Lagay ER , Baertschiger RM , Dinauer C , et al . Pediatric differentiated thyroid carcinoma:an update from the APSA Cancer Committee [J ] . J Pediatr Surg , 2020 , 55 ( 11 ): 2273 - 2283 .
Cordioli MI , Moraes L , Cury AN , et al . Are we really at the dawn of understanding sporadic pediatric thyroid carcinoma? [J ] . Endocr Relat Cancer , 2015 , 22 ( 6 ): R311 - R324 .
Dinauer CA , Breuer C , Rivkees SA . Differentiated thyroid cancer in children:diagnosis and management [J ] . Curr Opin Oncol , 2008 , 20 ( 1 ): 59 - 65 .
Bauer AJ . Molecular genetics of thyroid cancer in children and adolescents [J ] . Endocrinol Metab Clin North Am , 2017 , 46 ( 2 ): 389 - 403 .
Nies M , Vassilopoulou-Sellin R , Bassett RL , et al . Distant metastases from childhood differentiated thyroid carcinoma:clinical course and mutational landscape [J ] . J Clin Endocrinol Metab , 2021 , 106 ( 4 ): e1683 - e1697 .
Prasad PK , Mahajan P , Hawkins DS , et al . Management of pediatric differentiated thyroid cancer:an overview for the pediatric oncologist [J ] . Pediatr Blood Cancer , 2020 , 67 ( 6 ): e28141 .
Karapanou O , Tzanela M , Vlassopoulou B , et al . Differentiated thyroid cancer in childhood:a literature update [J ] . Hormones(Athens) , 2017 , 16 ( 4 ): 381 - 387 .
Schmidt Jensen J , Grønhøj C , Mirian C , et al . Incidence and survival of thyroid cancer in children,adolescents,and young adults in Denmark:a nationwide study from 1980 to 2014 [J ] . Thyroid , 2018 , 28 ( 9 ): 1128 - 1133 .
Sugino K , Nagahama M , Kitagawa W , et al . Distant metastasis in pediatric and adolescent differentiated thyroid cancer:clinical outcomes and risk factor analyses [J ] . J Clin Endocrinol Metab , 2020 , 105 ( 11 ): dgaa545 .
Vydro L , Kitahara CM , Lubin JH , et al . Among individuals irradiated for benign conditions in childhood,developing thyroid cancer does not affect all-cause survival [J ] . Thyroid , 2020 , 30 ( 3 ): 389 - 395 .
Lee YA , Jung HW , Kim HY , et al . Pediatric patients with multifocal papillary thyroid cancer have higher recurrence rates than adult patients:a retrospective analysis of a large pediatric thyroid cancer cohort over 33 years [J ] . J Clin Endocrinol Metab , 2015 , 100 ( 4 ): 1619 - 1629 .
Francis GL , Waguespack SG , Bauer AJ , et al . Management guidelines for children with thyroid nodules and differentiated thyroid cancer [J ] . Thyroid , 2015 , 25 ( 7 ): 716 - 759 .
国家儿童医学中心 , 国家儿童肿瘤监测中心 , 中华医学会小儿外科学分会 , 等 . 中国儿童甲状腺结节及分化型甲状腺癌专家共识 [J ] . 中华实用儿科临床杂志 , 2020 , 35 ( 20 ): 1521 - 1530 .
National Children's Medical Center, National Children's Cancer Surveillance Center, Pediatric Surgery Society of Chinese Medical Association,et al . Expert consensus on thyroid nodules and differentiated thyroid cancer for Chinese children [J ] . Chin J Appl Clin Pediatr , 2020 , 35 ( 20 ): 1521 - 1530 .
Koo JS , Hong S , Park CS . Diffuse sclerosing variant is a major subtype of papillary thyroid carcinoma in the young [J ] . Thyroid , 2009 , 19 ( 11 ): 1225 - 1231 .
Richman DM , Benson CB , Doubilet PM , et al . Thyroid nodules in pediatric patients:sonographic characteristics and likelihood of cancer [J ] . Radiology , 2018 , 288 ( 2 ): 591 - 599 .
Gupta A , Ly S , Castroneves LA , et al . A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults [J ] . J Clin Endocrinol Metab , 2013 , 98 ( 8 ): 3238 - 3245 .
Niedziela M , Breborowicz D , Trejster E , et al . Hot nodules in children and adolescents in western Poland from 1996 to 2000:clinical analysis of 31 patients [J ] . J Pediatr Endocrinol Metab , 2002 , 15 ( 6 ): 823 - 830 .
Nice T , Pasara S , Goldfarb M , et al . Pediatric papillary thyroid cancer >1 cm:is total thyroidectomy necessary? [J ] . J Pediatr Surg , 2015 , 50 ( 6 ): 1009 - 1013 .
Sugino K , Nagahama M , Kitagawa W , et al . Risk stratification of pediatric patients with differentiated thyroid cancer:is total thyroidectomy necessary for patients at any risk? [J ] . Thyroid , 2020 , 30 ( 4 ): 548 - 556 .
Hay ID , Johnson TR , Kaggal S , et al . Papillary thyroid carcinoma(PTC)in children and adults:comparison of initial presentation and long-term postoperative outcome in 4 432 patients consecutively treated at the mayo clinic during eight decades(1936-2015) [J ] . World J Surg , 2018 , 42 ( 2 ): 329 - 342 .
Spinelli C , Tognetti F , Strambi S , et al . Cervical lymph node metastases of papillary thyroid carcinoma,in the central and lateral compartments,in children and adolescents:predictive factors [J ] . World J Surg , 2018 , 42 ( 8 ): 2444 - 2453 .
Mao XC , Yu WQ , Shang JB , et al . Clinical characteristics and treatment of thyroid cancer in children and adolescents:a retrospective analysis of 83 patients [J ] . J Zhejiang Univ Sci B , 2017 , 18 ( 5 ): 430 - 436 .
Wang CY , Chen XH , Wei XY , et al . Recurrence factors and prevention of complications of pediatric differentiated thyroid cancer [J ] . Asian J Surg , 2017 , 40 ( 1 ): 55 - 60 .
Castinetti F , Waguespack SG , Machens A , et al . Natural history,treatment,and long-term follow up of patients with multiple endocrine neoplasia type 2B:an international,multicentre,retrospective study [J ] . Lancet Diabetes Endocrinol , 2019 , 7 ( 3 ): 213 - 220 .
Tuttle RM , Haugen B , Perrier ND . Updated American joint committee on cancer/tumor-node-metastasis staging system for differentiated and anaplastic thyroid cancer(eighth edition):what changed and why? [J ] . Thyroid , 2017 , 27 ( 6 ): 751 - 756 .
Klain M , Zampella E , Manganelli M , et al . Risk of structural persistent disease in pediatric patients with low or intermediate risk differentiated thyroid cancer [J ] . Endocrine , 2021 , 71 ( 2 ): 378 - 384 .
Seo GH , Kong KA , Kim BS , et al . Radioactive iodine treatment for children and young adults with thyroid cancer in south Korea:a population-based study [J ] . J Clin Endocrinol Metab , 2021 , 106 ( 7 ): e2580 - e2588 .
Hay ID , Gonzalez-Losada T , Reinalda MS , et al . Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008 [J ] . World J Surg , 2010 , 34 ( 6 ): 1192 - 1202 .
van Santen HM , Alexander EK , Rivkees SA , et al . Clinical considerations for the treatment of secondary differentiated thyroid carcinoma in childhood cancer survivors [J ] . Eur J Endocrinol , 2020 , 183 ( 3 ): P1 - P10 .
Sung TY , Jeon MJ , Lee YH , et al . Initial and dynamic risk stratification of pediatric patients with differentiated thyroid cancer [J ] . J Clin Endocrinol Metab , 2017 , 102 ( 3 ): 793 - 800 .
Pires BP , Jr Alves PAG , Bordallo MA , et al . Prognostic factors for early and long-term remission in pediatric differentiated thyroid carcinoma:the role of sex,age,clinical presentation,and the newly proposed American thyroid association risk stratification system [J ] . Thyroid , 2016 , 26 ( 10 ): 1480 - 1487 .
Kazahaya K , Prickett KK , Paulson VA , et al . Targeted oncogene therapy before surgery in pediatric patients with advanced invasive thyroid cancer at initial presentation:is it time for a paradigm shift? [J ] . JAMA Otolaryngol Head Neck Surg , 2020 , 146 ( 8 ): 748 - 753 .
Waguespack SG , Sherman SI , Williams MD , et al . The successful use of sorafenib to treat pediatric papillary thyroid carcinoma [J ] . Thyroid , 2009 , 19 ( 4 ): 407 - 412 .
Iyer P , Mayer JLR , Ewig JM . Response to sorafenib in a pediatric patient with papillary thyroid carcinoma with diffuse nodular pulmonary disease requiring mechanical ventilation [J ] . Thyroid , 2014 , 24 ( 1 ): 169 - 174 .
Mahajan P , Dawrant J , Kheradpour A , et al . Response to lenvatinib in children with papillary thyroid carcinoma [J ] . Thyroid , 2018 , 28 ( 11 ): 1450 - 1454 .
0
Views
6
下载量
1
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
