甲状腺未分化癌的预后影响因素分析

目的探讨甲状腺未分化癌的预后影响因素。方法回顾性分析2009年2月～2010年12月我院收治的甲状腺未分化癌患者126例,将搜集的资料建立数据库,分别进行单因素分析(即Log Rank法)和多因素分析(COX比例模型法)。结果 126例患者中的1、2和5年生存率分别为43.8%、31.2%和27.5%,中位生存时间为8个月。单因素分析结果显示,初诊时年龄<50岁、接受术后放疗且肿物最大直径<6cm的患者实施综合治疗预后效果相对较好;多因素分析显示白细胞计数<10×109个/L、原发灶最大直径等是决定甲状腺未分化癌预后效果的危险因素。结论影响甲状腺未分化癌患者预后效果的独立因素为白细胞计数及原发灶最大直径等,且大多数甲状腺未分化癌患者预后较差,肿瘤病灶局限于患者腺体内是影响甲状腺未分化癌预后的重要因素。

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Objective To explore the factors that influence survival of the patients with anaplastic thyroid carcinoma(ATC). Methods: The retrospective analysis was performed on the 126 ATC patients who were admitted in our hospital during Feb. 2009 and Dec. 2010. The clinical and pathological data were set up and analyzed by one-way analysis of variance (Log Rank method ) and multivariate analysis (Cox proportional hazard model).Results The median survival time of the 126 patients was 8 months, and the 1-, 2and 5-year survival rates were 43.8%, 31.2% and 27.5%, respectively. Results of the Log Rank method showed the prognostic effect was better when patients who got first diagnose at age of less than 50 and had the maximum diameter of tumor less than 6 cm after operation and radiotherapy received comprehensive therapy. Multivariate analysis results showed the risk factors were leukocyte less than 10×109·L-1 and the maximum diameter of primary tumor. Conclusion The factors independently influencing prognosis of ATC patients were numeration of leukocyte and maximum diameter of primary tumor. Prognosis of anaplastic thyroid cancer is generally poor. Tumor focus confined to the gland is also an important prognostic factor for the anaplastic thyroid cancer.