分化型甲状腺癌的多因素预后分析

Multivariate Prognosis Analysis of Differentiated Thyroid Carcinoma

目的探讨影响分化型甲状腺癌(differentiatedthyroidcarcinoma,DTC)预后的因素。方法回顾性收集1985年1月1日至1997年12月31日在中山大学肿瘤防治中心治疗的分化型甲状腺癌581例,对其预后进行单因素和多因素分析。结果581例分化型甲状腺癌的5、10、15年生存率分别为93.6%、87.5%和80.6%。单因素分析显示影响分化型甲状腺癌预后的因素有性别、年龄、肿瘤大小、T分期、远处转移、治疗方式、复发和临床病理分期,P<0.05,病理类型、淋巴结转移对预后无显著性影响,P>0.05。Cox多因素分析表明T分期、治疗方式和临床病理分期是影响分化型甲状腺癌预后的独立因素。结论性别、年龄、肿瘤大小、T分期、复发、远处转移和临床病理分期是影响分化型甲状腺癌预后的主要因素,其中T分期、治疗方式和临床病理分期为独立的预后因素。

[ Objective ] To investigate the factors that influence the prognosis of differentiated thyroid carcinoma （DTC） . [Methods] A total of 581 cases of DTC treated at Cancer Center, SUN Yat-Sen University from January 1st, 1985 to December 31st, 1997 were collected retrospectively, univariate and multivariate analyses were applied to analyze the prognosis of DTC. [Results] The overall 5-year, 10-year, and 15-year survival rates of 581 cases of DTC were 93.6%, 87.5%, and 80.6%, respectively. In univariate analysis, the factors that influenced the prognosis of DTC included gender, age, primary tumor size, T stage, distant metastasis, treatment pattern, recurrence and clinicopathological stage （P〈 0.05）, and the pathological type, lymph node metastasis had not significant influence on prognosis （P 〉0.05）. T stage, treatment pattern and clinicopathological stage were independent factors which influenced the prognosis of DTC according to Cox multivariate analysis. [Conclusion] Gender, age, primary tumor size, T stage, recurrence, distant metastasis and clinicopathological stage were main factors that influenced the prognosis of DTC and T stage, treatment pattern and clinicopathological stage were independent prognostic factors among them.