分化型甲状腺癌术后复发相关因素分析

目的探讨分化型甲状腺癌术后复发的相关因素,为复发的防治提供依据。方法回顾性分析2000年1月～2008年12月间经手术治疗的分化型甲状腺癌764例。通过系统随访详细记录复发可能的危险因素,并以Kaplan-Meier曲线描述复发情况,Log-rank检验和Cox比例风险模型分析复发影响因素。结果764例患者共失访32例,随访率95.8%。其余732例患者196例（26.8%）发生术后复发。其1、3、5和8年复发率分别为2.1%、5.8%、14.7%、25.4%。Log-rank检验和Cox比例风险模型分析显示患者年龄、原发肿瘤大小、转移情况、浸润程度、病理类型以及手术方式是影响复发的独立危险因素,其方程为：λ（t）=λ（0t）exp（0.871年龄＋0.981肿瘤大小＋1.245转移情况＋1.124浸润程度＋0.814病理类型＋1.348手术方式）。结论患者年龄、原发肿瘤大小、转移情况、浸润程度、病理类型以及手术方式是影响分化型甲状腺癌术后复发的独立危险因素。对于有高危复发因素的患者,应该加强术后随访。

Analysis of recurrence-related factors for differentiated thyroid carcinoma

[Objective] To identify recurrence-related factors of differentiated thyroid carcinoma （DTC）. [Methotis] 764 patients with DTC were selected. Disease-specific survival （DSS） rate was estimated with the KaplanMeier method. Univariate and multivariate comparisons were conducted by log-rank and Cox regression analysis. [Results] A total 764 cases, 732 cases was follow-up 95.8% of. 196 eases （26.8%） recurrence happened. Its oneyear, 3 years, 5 years, 8-year recurrence rates were 2.1%, 5.8%, 14.7%, 25.4% respectively, log-rank test and Cox proportional hazard model analysis showed that Patient＇s age, primary tumor size, metastasis, invasion, pathological type, as well as the impact of surgery were the independent risk factor for recurrence, the equation was： λ （t） = λ0（t） exp （0.871 age＋ 0.981 tumor size ＋1.245 tumor metastasis ＋1.124 infiltration ＋0.814 surgical pathological types ＋ 1.348 surgical method）. [Conchtsion] Patient＇s age, primary tumor size, metastasis, invasion, pathological type of surgery are the independent recurrence-related risk factor that impact the differentiated thyroid .cancer. Multimodali- ty long-term follow-up is warranted to highly recurred patients.