甲状腺未分化癌26例诊治疗效分析

Analysis of the clinical outcomes and treatment methods for 26 cases of undifferentated thyroid carcinoma

目的探讨甲状腺未分化癌诊治及影响疗效的因素。方法回顾性分析我院1990年至2005年收治的26例甲状腺未分化癌的临床资料，分别从治疗方法（手术加术后放疗，单纯手术），手术治疗（联合根治性切除术，姑息性切除术），首诊时白细胞值高低（〈1．0×10^10/L，≥1．0×10^10/L）方面分析其生存率。结果26例总的1，3，5年生存率分别为42．3％，30．78％，11．54％。手术加术后放疗组3年生存率（26．67％）明显高于单纯手术组（0．00％）（p=0．0161）；联合根治性切除术的患者3年生存率（21．43％）明显高于姑息性切除的患者（8’.33％）（p=0．0078）；首诊时白细胞≥1．0×10^10／L组，3年生存率（7．14％）明显低于白细胞〈1.0×10^10/L组（33．33％）（p=0．0007）。结论甲状腺未分化癌预后很差，根治性手术切除，手术加术后放疗等综合治疗可明显提高生存率。

Objective To investigate the therapeutic schemes and the factors that influence survival of the patients with undifferentated thyroid carcinoma （UTC）. Methods The clinical data of 26 patients with UTC admitted in our hospital from 1990 to 2005 were retrospectively analyzed.The survival rates were reviewd from the therapeutic scheme （surgery plus radiation and surgery alone）,the operation model （radical surgery and palliative surgery）,and the white cell count（〈1.0×10^10/L9≥1.0×10^10/L）. Results The overall 1 year, 3 year, 5 year survival rates of the 26 patients were 42.3%, 30.78% and 11.54% respectively.For the therapeutle scheme,the 3 year survival rate was 26.67% in group of surgery plus radiation, but was only 0.00% in group of surgery alone（p= 0.0161）.For the operation model, the 3 year survival rate was 21.43% in radical surgery group, but was only 8.33% in palliative surgery group（p=0.0078）.Based on the white cell count, the 3 year survival rate（7.14%）of the group with white cell count higher than 1.0×10^10/L was obviously lower than that of another group（33.33%p=0.0007）. Conclusion The prognosis of undifferentiated thyroid carcinoma is poor. But radical surgery and surgery plus postoperative radiation can obviously improve the survival rate.