分化型甲状腺癌患者术后复发转移指标临床意义及相关危险影响因素研究

Clinical Significance of Recurrence and Metastasis Index in Patients with Differentiated Thyroid Carcinoma and Related Risk Factors

目的探讨分化型甲状腺癌术后复发转移指标临床意义及相关危险影响因素。方法经手术治疗的80例分化型甲状腺癌患者,分析术后复发转移可能的危险因素,通过Kaplan-Meier曲线描述复发情况、甲状腺球蛋白的测定、Cox比例风险模型,分析复发的影响因素并进行对比分析。结果 80例患者中74例获随访,随访率达92.5%,随访的74例患者中有16例(21.6%)患者发生复发状况,其中术后2、4、6年的复发率分别为:3.7%、4.6%、7.3%。Log-rank检验和Cox比例风险模型分析显示甲状腺癌患者的身体素质、性别、原病情轻重、年龄、肿瘤的扩散转移情况,临床表现特征和手术方式及手术后的效果是术后复发的相关因素。其方程为:(t)=(t)exp(0.85年龄+0.96肿瘤大小+1.3转移情况+1.15临床表现特征+0.85病理类型+1.35手术方式)。结论甲状腺癌患者的身体素质、性别、原病情轻重、年龄、肿瘤扩散转移情况、临床表现特征、手术方式及手术后的效果是造成术后复发的危险影响因素。

Objective To investigate the clinical significance of recurrence and metastasis indicators in differentiated thyroid cancer and related risk factors. Methods 80 patients with differentiated thyroid carcinoma after surgery were selected. Detailed analysis of recurrence and metastasis potential risk faetors described by Kaplan-Meier curves of recurrence, the measurement of thyroglobulin, Cox proportional hazards model analysis of recurrence factors were analyzed. Results Among 80 patients, a total of 74 cases were followed up, follow up rate was 92.5% , among the 74 patients, 16 eases（ 21.6% ） had recurrence, in which 2-,4- and 6-year relapse rates were as follows ：3.7% ,4.6% ,7.3%. Log-rank test and cox proportional hazards model analysis showed that patients with thyroid cancer physique, sex, primary disease severity, age, tumor metastasis diffusion, clinical features and surgical procedures and post-operative effect was caused by the use of the technique after the relevant factors of recurrence. Its equation was： （t） = （t） exp （0.85 age ＋ 0.96 tumor size ＋ 1.3 metastasis ＋ 1.15 clinical features ＋ 1.35 surgical ＋ 0.85 pathology type）. Conclusion Thyroid cancer fitness,sex,primary disease severity,age,tumor spread metastasis,clinical features, surgical methods and effects are postoperative risk factors affecting recurrence.