分化型甲状腺癌预后相关因素分析并文献复习

Prognostic factors of differentiated thyroid carcinomas and review of literatures

对分化型甲状腺癌（DTC）预后相关因素进行分析并复习文献，为提高DTC诊断治疗水平及生存率提供依据。回顾性随访分析经术后组织病理学证实为DTC的150例（女性113例，男性37例）病例资料，乳头状癌131例（87．3％），滤泡癌19例（12．7％）。随访4．15～31年，存活140例（93．3％），复发30例（20．0％），死亡10例（6．7％）。手术方式中近全或次全切手术83例（55．3％），局部切除64例（42．7％），全切3例（2．0％）。63例行淋巴结切除者中45例（71．4％）检出淋巴结转移。发病年龄、就诊时肿瘤大小及早期转移率在死亡组与存活组、复发组与未复发组间有统计学差异（P〈0．05）。年龄、就诊时肿瘤大小及早期转移影响DTC预后。

Prognostic factors of differentiated thyroid carcinomas （ DTC ） were analyzed and the related literatures were systematically reviewed in order to justify the diagnostic and therapeutic modalities for improving the patient＇s survival. 150 patients （ female, n = 113 ; male, n = 37 ） with histopathologically diagnosed DTC, including papillary thyroid carcinoma （ n = 131, 87.3% ） and follicular thyroid carcinoma （ n = 19, 12. 7% ）, were postoperatively followed up and their clinical data were retrospectively reviewed. Patients were followed up for 4. 15- 31 years wherein 140 patients（93.3% ）survived but with relapse in 30 patients （20. 0% ）, and 10 patients （6. 7% ） died. Surgical procedures consisted of near-total or subtotal thyroidectomy （ n = 83, 55.3% ）, partial thyroidectomy （ n = 64, 42. 7 % ）, and total thyroidectomy （ n = 3, 2. 0% ）. Out of the patients receiving lymph node dissection （ n = 63）, 45 patients（71.4% ）had detectable lymph node metastasis. Age of onset, tumor size at initial visit, and early metastasis showed the statistically significant difference between mortality group and survival group （P 〈 0. 05 ）, as well as between relapse group and relapse-free group （ P〈0. 05 ）. Age of onset, tumor size at initial visit, and early metastasis are prognostic factors for DTC.