甲状腺癌的预后因素的相关分析

Correlated analysis of prognostic factors in patients with thyroid cancer

目的探讨临床病理特征、手术方式及辅助化疗对甲状腺癌预后的影响。方法回顾性分析2003年1月至2006年12月经本院普外科手术治疗的甲状腺癌患者200例。用Pearsonχ2分析肿瘤大小的分布差异,用Kaplan-Meier生存曲线统计生存率,Log-rank进行差异性检验,并对患者发病年龄、性别、病理类型、肿瘤大小、肿瘤部位、淋巴结转移、手术方式以及是否接受辅助化疗等因素进行Cox回归比例风险模型多因素分析。结果全组总的5年生存率为87.4%;单因素分析及多因素分析,年龄、淋巴结侵袭转移与否、分期是影响预后的独立因素。结论年龄、淋巴结转移与否、分期是影响预后的独立因素,要求进一步提高甲状腺癌诊断水平,正确评估预后,以便对甲状腺癌患者采取个体化的手术方案。

Objective To explore the impact of clinicopathologic features,operation mode and whether receiving chemotherapy on prognosis in Thyroid Cancer. Methods We analysed retrospectively 200 consecutive,surgically treated patients with pathologic Thyroid Cancer. Pearson chi-square test was used to compare the differences of distribution of the tumor size, Kaplan-Meier survival curve was performed to estimate the survival rate, statistical comparisons between curves were performed using the Log-rank test, and also a Cox proportional hazard regression model was used to make multivariate analysis of the incidence of age,gender,pathologic type,tumor size,tumor position,operation mode and whether receiving chemotherapy. Results The total survival rate of live years was 87.4%;single factor analysis and multiplicity indicated that the age,absorbent gland invasion and clinical staging were the independent factors respectively to affect the prognosis. Conclusion Owing the aging, absorbent gland invasion and clinical staging were independent prognosis factor for survival, the diagnosistic level should be improved, we should take systematic mediastinal lymphadenectomy positively,it could make the patient to obtain more early more thoroughgoing treatment.