术后残留低分化甲状腺癌的预后相关因素分析

Analysis of prognostic factors of postoperative residual poorly differentiated thyroid carcinoma

目的:评估术后残留低分化甲状腺癌患者的预后相关因素。方法:回顾性收集43例术后残留低分化甲状腺癌患者的性别、年龄、初诊时的中性粒细胞/淋巴细胞比值(neutrophils to lymphocytes ratio,NLR)(<4 vs≥4)、肿瘤局部侵犯(食管、气管、大血管)、淋巴结转移情况(N_(1a)vs N1b)、外照射放疗剂量(<66 Gy vs≥66 Gy)等因素,评估这些因素与5年总生存率的相关性。结果:43例术后残留低分化甲状腺癌患者的平均生存期为(2.82±0.25)年(95%置信区间:2.34~3.30),3年总生存率为39.53%,5年总生存率为25.58%。肿瘤侵犯大血管、NLR和术后外照射放疗剂量是5年总生存率的独立预后因素(P<0.05)。结论:NLR<4以及术后外照射放疗剂量≥66 Gy的术后残留低分化甲状腺癌患者的5年总生存率较高,肿瘤侵犯大血管患者的5年生存率差。

Objective:To evaluate the prognostic factors of patients with residual poorly differentiated thyroid carcinoma(PDTC).Methods:The Gender,age,neutrophils to lymphocytes ratio(NLR)at initial diagnosis(<4 vs≥4),local tumor invasion(esophagus,trachea,great vessels),lymph node metastasis(N_(1a)vs N1b)and external radiation dose(<66 Gy vs≥66 Gy)of 43 patients with residual PDTC were collected retrospectively.The correlation between these factors and 5-year overall survival rate was evaluated.Results:The mean survival time of 43 patients with residual PDTC was(2.82±0.25)years(95%confidence interval:2.34-3.30);the 3-year overall survival rate was 39.53%,and the 5-year overall survival rate was 25.58%.Tumor invasion of great vessels,NLR and postoperative external radiation dose were independent prognostic factors for 5-year overall survival(P<0.05).Conclusion:The 5-year overall survival rate of patients with residual PDTC with NLR<4 or receiving postoperative external radiation dose≥66 Gy was higher than that of patients with tumor invading great vessels.