CAJ | 학술논문

目的总结侵袭性分化型甲状腺癌的临床特征和治疗方法,探讨影响患者预后的因素.方法回顾性分析中山大学肿瘤防治中心头颈外科1985年1月-1997年12月收治的114例侵袭性分化型甲状腺癌患者的临床病理资料,评价治疗效果,对生存状况与预后因素进行统计分析.生存分析采用Kaplan-Meier法和Log-Rank检验,多因素分析采用Cox比例风险模型.结果初次治疗结束后,全组有68例带瘤生存(68/114,59.7%).全组患者的5年累积生存率为91.9%,10年累积生存率为80.1%,其中无肿瘤残留组、局部微小癌残留组和局部明显癌残留组的10年累积生存率分别为88.5%、78.5%和53.1%.年龄、侵犯食管和术后肿瘤残留情况是影响侵袭性分化型甲状腺癌患者预后的独立因素. 结论侵袭性分化型甲状腺癌的治疗应该以手术为主,彻底清除肿瘤是影响预后的关键因素;该类肿瘤预后较差,年龄、侵犯食管和术后肿瘤残留是影响预后的独立因素.
목적 총결침습성분화형갑상선암적림상특정화치료방법,탐토영향환자예후적인소.방법 회고성분석중산대학종류방치중심두경외과1985년1월-1997년12월수치적114례침습성분화형갑상선암환자적림상병리자료,평개치료효과,대생존상황여예후인소진행통계분석.생존분석채용Kaplan-Meier법화Log-Rank검험,다인소분석채용Cox비례풍험모형.결과 초차치료결속후,전조유68례대류생존(68/114,59.7%).전조환자적5년루적생존솔위91.9%,10년루적생존솔위80.1%,기중무종류잔류조、국부미소암잔류조화국부명현암잔류조적10년루적생존솔분별위88.5%、78.5%화53.1%.년령、침범식관화술후종류잔류정황시영향침습성분화형갑상선암환자예후적독립인소. 결론침습성분화형갑상선암적치료응해이수술위주,철저청제종류시영향예후적관건인소;해류종류예후교차,년령、침범식관화술후종류잔류시영향예후적독립인소.
Objective To evaluate the clinical characters, management and prognostic factors of patients with differentiated invasive thyroid carcinoma (DITC). Methods The data were analyzed retrospectively for 114 DITC patients treated at Department of Head and Neck Surgery of Sun Yat-sen University Cancer Center. Survival analysis was performed by Kaplan-Meier method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model. Results After surgery, 68 patients were with tumor residue. The 5-year and 10-year overall survival rate were 91.9% and 80.1% respectively in all patients, while the 10-year overall survival rate were 88.5% 、78.5% and 53.1% in no tumor residue group, micro-residue group and grossresidue group respectively. This study failed to prove that radiotherapy might improve the survival rate in patients with postoperative tumor residue. Multivariate analysis indicated that age, invasion to esophagus and recurrence predict the prognosis. Conclusion DITC may be treated mainly by surgical operation. Radical resection is the key factor in the treatment of DITC. Patients with DITC have a relatively poor prognosis.Age, esophagus invasion and status of tumor residue are the most important factors affecting the prognosis.