Abstract：
To describe the clinical features of a paediatric cohort affected by differentiated thyroid cancer (DTC) followed in a tertiary Department of Paediatric Endocrinology.
Clinical data of 41 patients affected by DTC in the 2000-2020 period were reviewed.
The main risk factor was autoimmune thyroiditis (39%). Cytological categories were TIR3b in 39%, TIR4 in 9.8%, TIR5 in 51.2%. After total thyroidectomy, radioiodine treatment was performed in 38 subjects (92.7%). ATA low-risk category was assigned in 11 (30.5%), intermediate-risk category in 15 (41.7%), and high-risk category in 10 patients (27.8%). Age at diagnosis was 15.1 ± 0.92 years in low-risk category, 14.7 ± 0.59 in intermediate-risk category, 11.7 ± 0.89 years in high-risk category (p = 0.01). TIR3b was manly observed in low-risk class (63.6%), while TIR5 was mainly reported in intermediate and high-risk class (60 and 80% respectively) (p = 0.04). Post-surgery stimulated thyroglobulin was increased in high-risk class (407.8 ± 307.1 ng/ml) [p = 0.04]. Tumour size was larger in high-risk category (42.6 ± 2.6 mm), than in low and intermediate-risk categories (19.4 ± 3.5 mm and 28.5 ± 3.9 mm, respectively) (p = 0.008). Patients in intermediate and high-risk categories displayed more tumour multifocality (60 and 90% respectively) (p < 0.005). Disease relapse was mainly observed in high risk category (40%, p = 0.04).
DTC in childhood is more aggressive than in adults, but the overall survival rate is excellent. The therapeutic approach is still heterogeneous, especially in low-risk category. Further studies are needed to standardise management and reduce disease persistence in childhood.
Clinical data of 41 patients affected by DTC in the 2000-2020 period were reviewed.
The main risk factor was autoimmune thyroiditis (39%). Cytological categories were TIR3b in 39%, TIR4 in 9.8%, TIR5 in 51.2%. After total thyroidectomy, radioiodine treatment was performed in 38 subjects (92.7%). ATA low-risk category was assigned in 11 (30.5%), intermediate-risk category in 15 (41.7%), and high-risk category in 10 patients (27.8%). Age at diagnosis was 15.1 ± 0.92 years in low-risk category, 14.7 ± 0.59 in intermediate-risk category, 11.7 ± 0.89 years in high-risk category (p = 0.01). TIR3b was manly observed in low-risk class (63.6%), while TIR5 was mainly reported in intermediate and high-risk class (60 and 80% respectively) (p = 0.04). Post-surgery stimulated thyroglobulin was increased in high-risk class (407.8 ± 307.1 ng/ml) [p = 0.04]. Tumour size was larger in high-risk category (42.6 ± 2.6 mm), than in low and intermediate-risk categories (19.4 ± 3.5 mm and 28.5 ± 3.9 mm, respectively) (p = 0.008). Patients in intermediate and high-risk categories displayed more tumour multifocality (60 and 90% respectively) (p < 0.005). Disease relapse was mainly observed in high risk category (40%, p = 0.04).
DTC in childhood is more aggressive than in adults, but the overall survival rate is excellent. The therapeutic approach is still heterogeneous, especially in low-risk category. Further studies are needed to standardise management and reduce disease persistence in childhood.
摘要：
目的：描述一个在儿科内分泌科接受分化型甲状腺癌（DTC）治疗的儿科队列的临床特征。
方法：回顾了2000-2020年期间41例DTC患者的临床资料。
结果：主要危险因素是自身免疫性甲状腺炎（39%）。细胞学类别为TIR3b，占39%，TIR4为9.8％，TIR5为51.2%。全甲状腺切除术后，38例(92.7%)接受放射性碘治疗.ATA低风险类别被分配在11个(30.5%)，15个中等风险类别(41.7%)，高危类别患者10例(27.8%)。低风险类别的诊断年龄为15.1±0.92岁，中等风险类别为14.7±0.59，高风险类别为11.7±0.89年（p=0.01）。TIR3b在低风险类别中观察到男子气概(63.6%)，而TIR5主要在中危和高危类别中报告（分别为60％和80％）（p=0.04）。手术后刺激的甲状腺球蛋白在高危类别中增加（407.8±307.1ng/ml）[p=0.04]。高危类别肿瘤大小较大（42.6±2.6mm），低于低风险和中等风险类别(19.4±3.5毫米和28.5±3.9毫米，分别)(p=0.008)。中等和高风险类别的患者表现出更多的肿瘤多灶性（分别为60％和90％）（p<0.005）。疾病复发主要在高风险类别中观察到(40%，p=0.04)。
结论：儿童时期的DTC比成人更具攻击性，但总体生存率很好。治疗方法仍然是异质的，尤其是低风险类别。需要进一步的研究来标准化管理和减少儿童疾病的持久性。
方法：回顾了2000-2020年期间41例DTC患者的临床资料。
结果：主要危险因素是自身免疫性甲状腺炎（39%）。细胞学类别为TIR3b，占39%，TIR4为9.8％，TIR5为51.2%。全甲状腺切除术后，38例(92.7%)接受放射性碘治疗.ATA低风险类别被分配在11个(30.5%)，15个中等风险类别(41.7%)，高危类别患者10例(27.8%)。低风险类别的诊断年龄为15.1±0.92岁，中等风险类别为14.7±0.59，高风险类别为11.7±0.89年（p=0.01）。TIR3b在低风险类别中观察到男子气概(63.6%)，而TIR5主要在中危和高危类别中报告（分别为60％和80％）（p=0.04）。手术后刺激的甲状腺球蛋白在高危类别中增加（407.8±307.1ng/ml）[p=0.04]。高危类别肿瘤大小较大（42.6±2.6mm），低于低风险和中等风险类别(19.4±3.5毫米和28.5±3.9毫米，分别)(p=0.008)。中等和高风险类别的患者表现出更多的肿瘤多灶性（分别为60％和90％）（p<0.005）。疾病复发主要在高风险类别中观察到(40%，p=0.04)。
结论：儿童时期的DTC比成人更具攻击性，但总体生存率很好。治疗方法仍然是异质的，尤其是低风险类别。需要进一步的研究来标准化管理和减少儿童疾病的持久性。
