影响甲状腺未分化癌预后的临床因素：—附32例报告

自1965年～1989年12月,我院共收治甲状腺未分化癌32例,男20例(62.5％),女12例(37.5％),年龄最小14岁,最大71岁,平均47.1岁。病史最长30年,最短20天,病史6个月内的15例(46.8％),>12个月的17例(53.2％),其中6例在就诊前均有迅速增大的表现。症状以甲状腺出现大而硬实的肿块为特征。同时伴有肿瘤局部浸润症状(呼吸困难,吞咽困难和声嘶)的共14例(43.8％)。淋巴结转移率为57.1％。由四种不同方案分别治疗4组病例:①单纯手术组;②手术加放疗组;③单纯放疗组;④未治疗组(只做活检或气管切开术)。治疗结果,3、5、10年生存率分别为37.5％(9/24),26.1％(6/23)和14.3％(3/20)。以手术加放疗的3、5年生存率分别为60％、50％。本文并就肿瘤局部浸润的程度,肿瘤大小、颈淋巴结转移、治疗方法、放射剂量等对生存率的影响进行了讨论。

THE CLINICAL STUDY OF UNDIFFERENTIATED THYROID CANCER-A REPOET OF 32 CASES

32 cases of undifferentiated thyroid carcinoma treated from 1965 to 1989 in our hospital were analysed . There were 20 males and 12 females. The youngest 14 years old. The oldest was 71 years old. The period of illness history range from 20 days to 30 years , among them 15 cases (46.8%) was shorter than 6 months, 17 cases(53.2%) more than 12 monthes. In 6 cases there was a history of rapid enlargement of the tumor shortly before admission. The main symptom was tumor mass to Ithe thyroid gland, however 13 cases (43.8%) had symptoms induced by tumor infiltration into the surrounding tissues ( dyspnea dysphagia and hoarsenss). The incidence of lymph node metastases was 57.1%. There were 4 types of curative treatment modalities: (1) operation alone; (2)oper atiqn plus radiotherapy ; (3) radiotherapy alone; (4) treatment (only biopsy or tracheotomy). The overall 3-, 5-, 10-year survival rates of the whole group were 37.5%, 26.1%and 14.3%, resphectively. The 3-, 5-years survival rates for the group of operation plus radiotherapy were 60% and 50% . The factors infenencing prognosis, including extent of tumor's infiltrstion, size of tumor, lymph nodes metastasis, thherapeutic modality and dose of radiotherapy. were discussed.