Thyroid tumor surveillance using ultrasound in childhood cancer survivors
Thyroid tumor surveillance using ultrasound in childhood cancer survivors
复制标题
DOI：
10.1111/ped.14179
复制
发表时间：
2020-05-01
影响因子：
1.4
通讯作者：
Nakazawa, Yozo
中科院分区：
文献类型：
--
作者：
Furui, Yu;Morita, Daisuke;Nakazawa, Yozo
在接受甲状腺放射治疗的儿童癌症幸存者（CCS）中进行甲状腺癌筛查的最佳方法仍有争议。我们描述了一个案例系列的超声监测甲状腺肿瘤的CCS在我们institute.Methods我们进行了甲状腺肿瘤的CCS与涉及甲状腺的放射治疗史的监测。基本的筛查方法是触诊。在向患者解释其益处和风险后，同意进行甲状腺超声检查。方法选取2014年10月至2018年9月在我院长期随访门诊就诊的82名患者作为研究对象。触诊无肿块。在39例CCS中进行了甲状腺超声检查，我们在27例中发现了甲状腺结节。4例患者的结节具有恶性回声特征。其中两例接受了活检，一名患者最终被诊断为早期甲状腺carcinoma.Conclusions照射在甲状腺的儿童癌症幸存者甲状腺结节的患病率高于一般人群。超声筛查有助于早期发现甲状腺癌，使我们能够进行最小手术。因此，超声波似乎是一个有用的选择二次甲状腺癌筛查。甲状腺肿瘤监测模式应根据个体病例考虑，患者必须得到关于获益和风险的明确解释。这些结果可以帮助医生考虑如何筛查继发性甲状腺癌。
Background The optimal method for thyroid cancer screening in childhood cancer survivors (CCSs) who received radiation involving the thyroid gland is still debated. We describe a case series of ultrasound surveillance for thyroid tumor in CCSs in our institute.Methods We conducted thyroid tumor surveillance for CCSs with a history of radiation therapy involving the thyroid. The basic screening method was palpation. Thyroid ultrasound was also performed for patients who agreed after its benefits and risks were explained to them. We surveyed CCSs who visited the long-term follow-up outpatient clinic in our institution between October 2014 and September 2018.Results Of 82 CCSs who visited our institution during the study period, 44 were eligible for inclusion. None had a mass identified by palpation. Thyroid ultrasound was performed in 39 CCSs, and we identified thyroid nodules in 27. Four patients had a nodule with malignant echo features. Two of these cases received biopsies, and one patient was ultimately diagnosed with an early stage thyroid carcinoma.Conclusions Childhood cancer survivors irradiated in the thyroid had a higher prevalence of thyroid nodules than the general population. Ultrasound screening contributed to early detection of impalpable thyroid cancer and enabled us to perform minimal surgery. Thus, ultrasound appears to be a useful option for secondary thyroid cancer screening. The thyroid tumor surveillance modality should be considered according to the individual case, and the patient must receive a clear explanation of the benefits and risks. These results could help doctors consider how to screen for secondary thyroid cancer.