<25岁甲状腺乳头状癌患者术后复发因素分析

Analysis of recurrence factors of thyroid papillary carcinoma patients younger than 25 years old

目的探究<25岁甲状腺乳头状癌(TPC)患者术后复发的危险因素,为此类患者诊疗提供临床依据。方法回顾分析2012—2015年间天津医科大学肿瘤医院收治的429例TPC患者临床病理资料,其中<25岁的104例,≥25岁的325例。比较两组患者复发率及临床病理特征差异,并对影响<25岁术后复发因素进行Logrank单因素、Cox模型多因素分析。结果<25岁TPC患者比≥25岁TPC患者原发肿瘤直径更小,手术切除范围相对较小,术后复发率高。单因素分析结果显示原发肿瘤个数≥2个、最大肿瘤直径≥2 cm、未行全甲状腺切除术与<25岁TPC患者术后复发相关(P均<0.05)。多因素分析结果显示原发肿瘤个数≥2个、最大肿瘤直径≥2 cm是<25岁TPC患者术后复发危险因素。结论原发肿瘤个数≥2个、最大肿瘤直径≥2 cm是预测术后复发危险因素,为临床上诊疗<25岁TPC患者提供有力依据。

Objective This study aims to investigate the risk factors for postoperative recurrence in patients under 25 years old with thyroid papillary carcinoma(TPC),and to provide more reference for the diagnosis and treatment.Methods The clinicopathological data of 429 patients with thyroid papillary carcinoma(TPC)admitted to Tianjin Medical University Cancer Hospital from 2012 to 2015 were analyzed retrospectively,including 104 patients under 25 years old and 325 patients over 25 years old.The recurrence rate and clinicopathological characteristics of the two groups were compared,and the factors influencing the recurrence of patients younger than 25 years old were analyzed by log-rank single factor and Cox model.Results The diameter of primary tumor,surgical resection range and the recurrence rate in patients with TPC<25 years old are smaller than that in patients with TPC≥25 years old.The results of univariate factor analysis showed that the number of primary tumors≥2,the largest tumor diameter≥2 cm,and the absence of total thyroidectomy were related to the postoperative recurrence of TPC patients<25 years old(all P<0.05).The results of multivariate analysis showed that the number of primary tumors≥2 and the maximum tumor diameter≥2 cm were the risk factors of postoperative recurrence in TPC patients<25 years old.(all P<0.05).Conclusions The number of primary tumors≥2 and the maximum tumor diameter≥2 cm are independent risk factors for predicting postoperative recurrence,providing evidence for the clinical treatment of patients under 25 years old with thyroid papillary carcinoma.