甲状腺滤泡癌105例预后分析

目的 分析甲状腺滤泡癌的临床生物学特征及影响预后的因素.方法 回顾性分析1970-1990年间天津市肿瘤医院收治的105例甲状腺滤泡癌患者的临床资料.结果 本组病例5、10和15年生存率分别为85.3％、76.7％和72.9％.≥45岁及＜45岁患者15年生存率分别为45.9％、89.8％.双侧腺叶及单侧腺叶发病患者15年生存率分别为50.0％、76.2％.有颈淋巴结转移及无颈淋巴结转移患者15年生存率分别为54.2％、79.2％.AJCC分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者15年生存率分别为89.3％、70.0％、45.5％、35.3％.随访中11例发生远处器官转移,发生转移时间为术后1 ～33年,9例在发生转移后5年内死亡.17例发生局部复发,复发时间为术后3个月至34年,10例因复发死亡,占55.8％.结论 甲状腺滤泡癌患者的年龄、临床分期、双侧甲状腺叶发病和颈部淋巴结转移与预后关系密切.早期诊治和密切随访是改善患者预后、延长术后生存的主要手段.

Follicular thyroid carcinoma: an analysis of 105 cases

Objective To investigate clinical biologic characteristics and factors that impact prognosis of patients with follicular thyroid carcinoma(FTC).Method Clinical data of 105 FTC patients treated surgically in the Department of Head& Neck,Tianjin Cancer Hospital from 1970 to 1990 was analyzed retrospectively.Results The overall 5-year,10-year and 15-year survival rates of these patients were 85.3％,76.7％ and 72.9％ respectively.The overall 15-year survival rates of patients ≥45 years and those ＜ 45 years were 45.9％,89.8％ respectively.The overall 15-year survival rates of patients with unilateral and bilateral carcinoma was 50.0％,76.2％ respectively.The overall 15-year survival rates of patients with neck lymph node metastasis and without were 54.2％,79.2％ respectively.The overall 15-year survival rates of patients at stage Ⅰ,stage Ⅱ,stageⅢ and stageⅣ were 89.3％,70.0％,45.5％ and 35.3％respectively.During the follow-up period,11 patients were diagnosed with distant metastasis from 1 year to 33 years after surgical treatment and 9 died of cancer within 5 years after diagnosis.Seventeen patients had local recurrence from 3 months to 34 years after surgery and 10 of these patients died of local recurrence.Conclusions The factors influencing prognosis of patients with FTC were age,clinical stage,bilateral carcinoma and neck lymph node metastasis,therefore early treatment and close following-up are essential to improve the prognosis of patients with FTC.