儿童和青少年甲状腺癌临床管理的研究进展

Advances in clinical management of thyroid cancer in children and adolescents

摘要:

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。

Abstract:

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.