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;
YIN Detao, Email: detaoyin@zzu.edu.cn
papillary thyroid cancer; adolescents; lateral lymph node metastasis; recurrence
10.7507/1007-9424.202403033
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Objective To summarize the clinical and pathological 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 (adult group) were randomly selected. 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 lymph node metastasis in the lateral cervical region 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) 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=7.508, 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 lymph node dissection in the cervical area; and adolescent PTC patients with lymph node metastasis and distant metastasis should pay close attention to their recurrence status.