晚期甲状腺癌的预后分析

Prognostic analysis of advanced thyroid carcinoma

目的探讨影响晚期甲状腺癌预后的相关因素。方法1996年3月-2008年1月期间手术治疗为主的25例晚期甲状腺癌患者，术后随访，采用Kaplan-Meier法计算累积生存率，并在单因素分析基础上，进一步应用Cox回归模型进行预后的多因素分析。结果全组患者3年和5年生存率分别为86．4％、62．7％。单因素分析显示，年龄（P=0．0383）、周围解剖区域有无侵犯（P=0．0054）、临床分期（P=0．0033）、有无复发和转移（P=0．0041）以及术后是否坚持服用甲状腺素（P=0．0003）均为影响患者预后的相关危险因素，但多因素分析结果仅提示术后是否坚持服用甲状腺素（P=0．0076）是影响预后的独立因素。结论术后是否坚持服用甲状腺素对于晚期甲状腺癌患者预后有重要意义，应密切随访并督促其按时服药。

Objective To investigate the prognosis-related risk factors for patients with advanced thyroid carcinoma on the basis of survival rate survey. Methods Included in this study were 25 cases with advanced thyroid carcinoma treated in our Hospital mainly by surgical therapy fi＇om Mar. 1996 to Jan. 2008, with the procedures of Kaplan-Meier taken to sum up the accumulated survival rate. Then, Cox model was utilized to do a multivariate analysis to explore the prognosis-related risk factors for these cases, following the analysis of single-factor exploration among them. Results The 3- and 5-year survival rates were 86.4% and 62.7% for this group of patients respectively as evaluated by the procedures of Kaplan-Meier taken. As the results of single-factor analysis on the prognosis-related risk factors for these cases, closely associated with their prognosis were these as age, adjacent tissue encroachment, clinical staging, local reoccurrence and metastasis, as well as regularly oral taking thyroxine after operation, with their statistically significant levels being at P^0.0383, 0.0054, 0.0033, 0.0041 and 0.0003 respectively. However, whether or not regularly oral taking thyroxine after the operation was evaluated as the only prognosis-related independent risk factor for these cases based on the multivariate analysis （P=0.0076）. Conclusions It is very important to follow up the patients with their advanced thyroid carcinoma operated on to supervise and urge them regularly oral taking thyroxine in order to have a good prognosis.