甲状腺全切术对分化型甲状腺癌的治疗效果及对患者血清学指标及预后的影响

Therapeutic effect of total thyroidectomy in patients with differentiated thyroid cancer and the influence on serum markers and prognosis of patients

目的讨论甲状腺全切术对分化型甲状腺癌的治疗效果及对患者血清学指标及预后的影响。方法依据治疗方式将76例分化性甲状腺癌患者分为观察组(n=40)和对照组(n=36),观察组患者接受甲状腺全切术治疗,对照组患者接受甲状腺近全切术治疗。比较两组患者的临床疗效;比较两组患者血钙、甲状旁腺激素(PTH)水平及血清学指标水平的变化,比较两组患者的预后情况。结果治疗后,观察组患者临床总有效率为92.5%,明显高于对照组患者的66.67%,差异有统计学意义(P﹤0.05)。观察组患者症状控制时间、平均住院时间均明显短于对照组患者,差异有统计学意义(P﹤0.05)。手术后3天,两组患者血钙、PTH、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、半乳糖凝集素-3(Gal-3)、血管内皮生长因子(VEGF)水平均低于本组治疗前,且观察组患者血钙、PTH、TNF-α、IL-6、Gal-3、VEGF水平均低于对照组患者,差异均有统计学意义(P﹤0.05)。随访1年,观察组患者复发率明显低于对照组患者,差异有统计学意义(P﹤0.01);但两组患者转移率、生存率、并发症发生率比较,差异均无统计学意义(P﹥0.05)。结论甲状腺全切术治疗分化型甲状腺癌疗效显著,可有效降低复发率,降低炎性因子水平,对改善患者的预后意义重大。

Objective To discuss the therapeutic effect of total thyroidectomy in patients with differentiated thyroid cancer and on the changes in serum markers and prognosis of patients.Method A retrospective analysis of the clinical data of 76 patients with differentiated thyroid cancer was performed,according to different treatment methods administered,this cohort of patients was divided into two groups as study group(n=40)and control group(n=36),patients in study group were given total thyroidectomy,and those in control group were treated with subtotal thyroidectomy.The clinical efficacy,serum calcium,parathyroid hormone(PTH)levels and serum marker levels were compared between the two groups,besides,the prognosis of the two groups were also assessed and compared.Result After treatment,the clinical overall response rate in study group was 92.5%,which was evidently higher than that in control group at 66.67%(P<0.05).The time of symptom control and the average time of hospital stay were significantly shorter in study group versus control group(P<0.05).In 3 days post surgery,the blood calcium,PTH,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),galectin-3(Gal-3),and vascular endothelial growth factor(VEGF)levels in both groups were decreased,and significantly lower levels of these markers were observed in study group comparing to control group(P<0.05).After 1 year of follow-up,the recurrence rate of the study group was significantly lower than that of the control group(P<0.01);while there was no significant difference in metastasis rate,survival rate and incidence of complications between the two groups(P>0.05).Conclusion Total thyroidectomy demonstrates significant effect in the treatment of differentiated thyroid cancer,which can effectively reduce the recurrence rate and lower the level of inflammatory factors in patients,with great significance for improving the prognosis of patients.