关键词: 儿童, 分化型甲状腺癌, 131I治疗, 致癌基因融合, 动态风险分层, 刺激性甲状腺球蛋白

Abstract: Radioactive iodine therapy for children differentiated thyroid cancer        SONG Juan-juan*, LIN Yan-song. *Department of Nuclear Medicine, Peking University International Hospital, Beijing 102206, China
Corresponding author：LIN Yan-song, E-mail:linys@pumch.cn
Abstract    The clinicopathological features and long-term prognosis of children differentiated thyroid cancer（cDTC）are significantly different from that of adult DTC（aDTC），thus the diagnosis and management strategies for adults cannot be completely applicable to cDTC. Currently, 131I therapy recommendations for cDTC are based primarily on recurrence risk stratification. Compared with aDTC，the international guidelines for cDTC recurrence risk stratification have limited evidence and focus more on lymph node metastasis. Recent studies have revealed the relationship between gene characteristics and invasion and differentiation of cDTC，which add new evidence for the recurrence risk of cDTC，and will help guide the evaluation and efficacy predicting before 131I therapy. Gene expression was associated with aggressive clinical behavior and may afford evidence in the future 131I management in cDTC, as well as provide opportunities to incorporate oncogene-specific inhibitory therapy for re-differentiation in those 131I-refractory cDTC. DRS system and sTg levels may be used for pre-131I evaluation and disease status follow-up in the decision making for cDTC. The above advancements are expected to provide basis for individualized assessment and decision making of 131I management in cDTC.

Key words: children, differentiated thyroid cancer（cDTC）, 131I therapy, oncogenic fusion, dynamic risk stratification（DRS）, stimulated thyroglobulin（sTg）