Influencing factors for lung metastasis of differentiated thyroid carcinoma in children and adolescents
Objective To analyze the influencing factors for lung metastasis of differentiated thyroid carcinoma in children and adolescents(≤18 years old).Methods A retrospective analysis was conducted on 255 cases of differentiated thyroid carcinoma in children and adolescents treated at Zhejiang Cancer Hospital from January 2010 to October 2022.Patients were divided into observation group(n=45)and control group(n=210)based on whether lung metastasis occured.Clinical,ultrasonographic,and pathological characteristics of the two groups were compared,and univariate and multivariate logistic regression analysis was used to identify the independent influencing factors for lung metastasis.Results Patients in the observation group were younger than the control group,the proportion of patients with postoperative high stimulated thyroglobulin(sTg)and tumor diameter were larger than those of control group,and the proportion of burr structure was higher than that of control group,all with statistical significance(all P<0.05).Multivariate logistic regression analysis showed that high postoperative sTg level,large tumor diameter,multifocality of the tumor,extrathyroidal extension,and central region and lateral neck lymph node metastasis were independent risk factors for lung metastasis in children and adolescents with differentiated thyroid carcinoma(all P<0.05),while a larger age was a protective factor(P<0.05).Conclusion In children and adolescents with differentiated thyroid carcinoma,patients who are younger,have higher postoperative sTg levels,larger tumor diameters,multiple tumor foci,extrathyroidal extension,and central region and lateral neck lymph node metastasis should be vigilant for the occurrence of lung metastasis.Early screening and targeted treatment are warranted.