210例甲状腺癌临床病理特征及预后分析

The analysis of clinicopathologic features and prognosis for 210 patients with thyroid cancer

目的探讨甲状腺癌的临床病理特点和预后影响因素。方法选取2011年6月至2013年6月间收治并行手术治疗的甲状腺癌患者210例,分析患者的临床特点和治疗以及预后的主要影响因素。结果 210例甲状腺癌患者中,女性所占比率高于男性（男女之比为1∶1.9）,差异有统计学意义（P〈0.05）。≥45岁患者所占比例高于〈45岁患者,差异有统计学意义（P〈0.05）。67.6%的患者术前超声检出为甲状腺癌。病理类型主要为乳头状腺癌（73.8%）和滤泡状腺癌（26.2%）,这两种类型均为分化型甲状腺癌。病理分期为Ⅰ-Ⅱ期113例（53.8%）,Ⅲ-Ⅳ期97例（46.3%）。Logstic回归分析显示,临床分期（OR=4.445,P〈0.05）、淋巴结转移（OR=3.213,P〈0.05）、年龄（OR=2.001,P〈0.05）、多中心癌灶（OR=1.567,P〈0.05）为影响患者预后的独立危险因素。结论甲状腺癌以分化型病理类型为主,影响患者预后的因素较多,应根据患者的临床特征实施个体化的治疗方案。

Objective To investigate the clinicopathologic features and prognosis of 210 patients with thyroid cancer,provide reference for clinical diagnosis and treatment of thyroid cancer. Methods From June 2011 to June 2013,210 patients with thyroid cancer in were enrolled into this study. The clinicopathologic features and prognosis of these patients were analyzed. Results Among all the patients,the incidence of the thyroid cancer of female was higher than male（ 1： 1. 9）,the difference was significant（ P〈0. 05）; the incidence of the thyroid cancer of patients more than 45 years was higher than that in the patients less than45 years,the difference was significant（ P〈0. 05）. The B ultrasonic detection rate of preoperative was 67. 6%. The main pathology type were papillary adenocarcinoma（ 73. 8%） and follicular carcinoma（ 26. 2%）,both of these were differentiated thyroid cancer. 113 patients（ 53. 8%） were in Ⅰ - Ⅱstage,97 patients（ 46. 2%） were in Ⅲ - Ⅳ stage. Logstic regression analysis showed that clinical stage（ Ⅲ - Ⅳ period）（ OR = 4. 445,P〈0. 05）,lymph node metastasis（ OR = 3. 213,P〈0. 05）,Age（ ≥ 45 years old） OR = 2. 001,P〈0. 05）,multi-center foci（ OR = 1. 567,P〈0. 05） were the independent risk factors for prognosis. Conclusion The mainly pathology type of thyroid cancer is differentiated histological type,and many factors can affect the prognosis,which indicates that individualized treatment therapy should be implemented for the treatment of thyroid cancer.