新疆146例分化型甲状腺癌患者的预后因素分析

Prognostic factors analysis in 146 different national patients with differentiated carcinoma of thyroid in Xinjiang

为了探讨影响新疆地区分化型甲状腺癌(DTC)患者预后的相关因素,回顾性分析新疆医科大学第一附属医院2002-01-2006-12收治的146例DTC患者的临床资料,用Kaplan-Meier法分析患者的总生存率,用Log-rank检验和Cox模型对影响患者生存的临床病理因素和治疗方法进行单因素和多因素分析。患者5年总生存率为91.8%。单因素分析结果显示,性别、年龄、族别、地区分布、原发肿瘤大小、淋巴结转移、远处转移、肿瘤侵犯程度、口服甲状腺素片以及吸碘治疗,10个因素是患者预后的影响因素(P值均<0.05);多因素分析显示,年龄、淋巴结转移、远处转移以及肿瘤侵犯程度为影响患者预后的独立因素。初步研究结果提示,对于新疆不同民族DTC的患者,年龄<45岁、无远处转移、无淋巴结转移及包膜内型患者的生存率高,预后好。

The aim of this study was to indentify and measure the prognostic factors in different national patients with differentiated carcinoma of thyroid in Xin Jiang region.The clinicopathologic data of 146 differentiated carcinoma of thyroid patients were analyzed retrospectively in the First Affiliated Hospital of Xinjiang Medical University from January 2002 to December 2006.All patients underwent radical or palliative throidectomy firstly at the First Affiliated hospital of Xin Jiang Medical University.The Kaplan-Meier method was applied to analyze survival rates,Log-rank test was applied in the univariate analysis,and multivariate Cox model analysis was applied to perform the independent prognostic factors of the patients.The 5-year survival for total cases were 91.8%.Univariate analysis indicated that sex age,national,regional distribution,primary tumor size,lymph node metastases,distant metastasis,extent of tumor invasion,thyroxine prophylaxis,radioactive iodine remnant ablation were prognostic factors（P〈0.05）.Multivariate analysis showed that only age,lymph node metastasis,distant metastasis,extent of tumor invasion were independent prognostic factors.In conclusion,age,lymph node metastases,distant metastasis,extent of tumor invasion are the independence prognosis factor for differentiated carcinoma of thyroid patients in Xin Jiang.