青年甲状腺癌的临床病理特点及复发因素分析

Clinical and pathological features of thyroid carcinoma and analysis of recurrence factors in adolescents

目的:探讨青年甲状腺癌患者临床病理特点以及影响复发的主要因素。方法 :回顾性分析1995年1月-2006年12月163例18~30岁青年甲状腺癌患者临床病理资料,分析临床病理特征与复发间的关系。结果:青年甲状腺癌复发与肿瘤大小、淋巴结转移、手术方式、TSH抑制水平、复发危险度分层及是否行^(131)I治疗相关(P<0.05);与性别、是否为多灶性、肿瘤分期、病理类型及包膜是否完整无明显相关(P>0.05)。多因素分析显示,淋巴结转移和术后TSH抑制水平是影响青年甲状腺癌患者复发的危险因素。结论:青年甲状腺癌预后较好,依据肿瘤大小、包膜浸润情况、淋巴结转移等进行个体化手术方案,结合分化型甲状腺癌复发危险度分层规范随访监测及术后治疗,可降低患者复发率。

Objective： To detect the risk factors that influence the recurrence of thyroid cancer in young adult. Methods： From January,1995 to decnmber,2006, the data included clinical features and pathology features of 163 cases in Juxian Traditional Chinese Medical Hospital aged 18 to 30 were analyzed and the multi factor regression analysis was used to analyze the risk factors. ResutlS： The recurrence of young adult thyroid cancer was not correlated to the gender, age, multifocal, TNM, pathology and thyroid capsule of the patients （P〉0.05）, but was correlated to the tumor＇s size, lymph node positive, operation mode, TSH levels ,recurrence risk stratification and the removal of residual thyroid tissue （.P〈0.05）;The Logistic regression analysis showed that lymph node metastasis resection and postoperative TSH level were all the risk factors. Conclusion： Young adult cases are more likely to have good prognosis. Individualized surgical plan, standard post-operation and follow-up according to the differentiated thyroid cancer （DTC） recurrence risk stratification can reduce the recurrence.