影响中青年分化型甲状腺癌患者预后因素的临床分析

目的探讨影响中青年分化型甲状腺癌者的预后因素。方法对治疗中青年全部分化型甲状腺癌患者的资料进行单因素和多因素分析。结论181例中青年分化型甲状腺癌的10年生存率为93·6%。单因素分析显示影响分化型甲状腺癌预后的因素有年龄、肿瘤大小、T分期、远处转移、治疗方式和临床病理分期(P<0·05),性别、病理类型、淋巴结转移对预后无显著性影响(P>0·05)。多因素分析表明远处转移是影响中青年分化型甲状腺癌预后的独立因素。结论年龄、肿瘤大小、T分期、远处转移和临床病理分期是影响中青年分化型甲状腺癌预后的主要因素,其中远处转移为其独立的预后因素。有远处转移的患者,行全或近全甲状腺切除术,术后行131I内照射治疗可能有利于提高其生存率。

The clinical analysis of the factors that influence the prognosis of differentiated thyroid carcinoma (DTC) in the young-middle patients

Objective To investigate the factors that influence the prognosis of differentiated thyroid carcinoma(DTC) in the young-middle patients.Methods A total of 181 cases of DTC treated at China-japan friendship hospital,were collected,univariate and multivariate analyses were applied to analyze the prognosis of DTC.Results The overall 10-year survival rates of 181 cases of DTC were 93.6% respectively.In univariate analysis, the factors that influenced the prognosis of DTC included age, primary tumor size, T stage, distant metastasis, treatment pattern and clinical pathological stage (P<0.05), and the gender,pathological type, lymph node metastasis had not significant influence among on prognosis (P>0.05).Distant metastasis was the independent factor which influenced the prognosis of DTC according to Cox multivariate analysis.Conclusion Age, primary tumor size, T stage, recurrence, distant metastasis and clinicopathological stage were main factors that influenced theprognosis of DTC and distant metastasis was the factor influencing survival significantly.The prognosis of these patients without distant metastasis is good.Total or near-total thyroidectomy and postoperative ~131I therapy may be essential for a better prognosis in patients with distant metastasis.