JCEM:小儿和青少年分化型甲状腺癌的远处转移

2020-08-20 MedSci原创 MedSci原创

为了获得RAI治疗的全部功效,需要在出现明显转移之前及早诊断DM。对于儿童和青少年DTC,选择性疗法将更可取。

与成人分化型甲状腺癌(DTC)相比,小儿和青少年DTC的特点是远处转移(DM)更为频繁。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在调查该人群中DM的临床结局,并分析与DM相关的危险因素。

研究人员回顾性地分析了1979年至2014年期间接受手术治疗的171例19岁的DTC患者病历。该研究的主要结局指标为美国甲状腺协会(ATA)指南中针对成人DTC和RECIST标准评估的对放射性碘(RAI)治疗的临床反应。研究人员评估了无远处转移生存(DMFS)相关的危险因素。

研究人员在29例患者中观察到了DM,所有患者均为肺转移。肺转移的模式分为3类:大结节、微结节和无明显结节(仅通过RAI闪烁显像法检测)。在没有明显结节的患者中,最经常观察到根据ATA指南标准或RECIST标准的CR反应良好的患者。与DMFS相关的重要因素包括性别、临床淋巴结转移(LNM)、甲状腺外扩张和LNM数量。根据危险因素的数量将受试者分为三组:低危险(无危险因素)、中等风险(1个危险因素)和高风险(≥2个危险因素)。低、中和高风险组的20年DMFS发生率分别为99.0%、71.7%和28.6%。

由此可见,为了获得RAI治疗的功效,需要在出现明显转移之前及早诊断DM。对于儿童和青少年DTC,选择性疗法将更可取。

原始出处:

Kiminori Sugino,et al.Distant metastasis in pediatric and adolescent differentiated thyroid cancer: Clinical outcomes and risk factor analyses.JCEM.2020.https://doi.org/10.1210/clinem/dgaa545

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    2020-11-25 smallant2015
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    2021-06-27 achengzhao
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