甲状腺滤泡性肿瘤Logistic判别分析及预后分析

本文对１６９例滤泡性甲状腺肿瘤进行了研究，包括８５例滤泡性腺癌（ＦＣ），６１例滤泡性腺瘤（ＦＡ）和２３例未定性滤泡性肿瘤（ＵＦＴ）。逐步回归分析被用于筛选ＦＣ与ＦＡ的主要鉴别指标，选出１２项病理指标，并以此建立ｌｏｇｉｓｔｉｃ判别方程，用于ＦＣ与ＦＡ的判别，符合率为１００％，表明该方程对甲状腺滤泡性肿瘤的诊断有实用价值。１４１例（８３．４％）获随访结果，其中１１６例（８２％）随访达１０年以上。统计学分析显示ＦＣ、ＦＡ和ＵＦＴ的局部复发率差异无显著性，而转移率和病死率差异显著，后两者仅见于ＦＣ；两型ＦＣ［微小浸润型（ＭＩＣ）和明显浸润型（ＷＩＣ）］的生存率差异显著，ＭＩＣ１０年生存率为９７．３％，而ＷＩＣ为６０．８％；１１项临床病理指标与ＦＣ的顶后有明显关系。

Logistic discrimination analysis and prognostic analysis of thyroid follicular tumors

cases of follicular thyroid tumors including 85 follicular carcinomas (FC), 61 follicular adenomas (FA) and 23 undetermined follicular tumors(UFT) were investigated.Stepwise regression analysis was applied to find out the main indexes in differentiation between FC and FA. Twelve pathological indexes were selected out to establish the logistic discriminant equation which was used in judgement of FC and FA.The consistent rate was 100%.This equation was proved to be of practical value in the diagnosis of follicular thyroid tumors. The follow-up information was obtained in 141 cases (83.4%) in which 116 cases (82%) were followed up for more than 10 years. The rates of local recurrence of FC. FA and UFT were not statistically different, but the rates of metastasis and mortality, which only occurred in FC, were statistically different. The survival rates were strikingly different between the two types of FC,the minimally invasive carcinoma(MIC) and the widely invasive one (WIC).The 10 year survival rate of MIC was 97.3%, but 60. 8% in WIC. The eleven clinico-pathological indexes possessing significant relationship with the prognosis of FC have been demonstrated.