Nowak Wojciech, Szybiński Piotr, Nowak Krystyna, Stachura Jerzy, Popiela Tadeusz
I Katedry Chirurgii Ogólnej i Kliniki Chirurgii Gastroenterologicznej, Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Wiad Lek. 2004;57(9-10):431-7.
The aim of this study was to evaluate the influence of suspected prognostic factors on survival in the endemic goiter area. The retrospective review of 208 consecutive patients with differentiated thyroid cancer treated at I Department of General Surgery Collegium Medicum Jagiellonian University from 1983 to 1996. In the studied population there were 98 patients (47.1%) with follicular cancer and 110 patients (52.9%) with papillary cancer. The 182 (87.5%) female and 26 (12.5%) male patients had mean age 48.8 (range from 16 to 80 years). The mean follow-up period was 11.7 years with the longest time of observation 19 years and the shortest 6 years. All the patients were living in the endemic area. Patients with differentiated thyroid cancer have very good prognoses. The 10 year survival rate in case of follicular and papillary cancer were 87.6% and 90.24% respectively. The univariate analysis identified sex, age, histological subtypes (insular and tall cells variants), extrathyroidal extension, size of the tumour beyond 70 mm, lymph node and distance metastases as well as type of surgical procedures in III stage of disease as significant prognostic factors with major effect on survival. In the multivariate analysis extrathyroidal extension, distance metastases, recurrence and lymph node metastases influenced the survival. Early detection of differentiated thyroid cancer with the help of ultrasound examination with aspiration biopsy of suspected lesions, radical surgical procedures and good histological evaluation of the removed tissues guarantee very good treatment results.
本研究的目的是评估在地方性甲状腺肿地区，可疑预后因素对生存的影响。回顾性分析了1983年至1996年在雅盖隆大学医学院普通外科一部接受治疗的208例连续分化型甲状腺癌患者。在研究人群中，有98例（47.1%）滤泡状癌患者和110例（52.9%）乳头状癌患者。182例（87.5%）女性和26例（12.5%）男性患者的平均年龄为48.8岁（范围为16至80岁）。平均随访期为11.7年，最长观察时间为19年，最短为6年。所有患者均生活在地方性甲状腺肿地区。分化型甲状腺癌患者的预后非常好。滤泡状癌和乳头状癌的10年生存率分别为87.6%和90.24%。单因素分析确定性别、年龄、组织学亚型（岛状和高细胞变体）、甲状腺外侵犯、肿瘤大小超过70mm、淋巴结和远处转移以及疾病III期的手术方式是对生存有重大影响的显著预后因素。多因素分析显示，甲状腺外侵犯、远处转移、复发和淋巴结转移影响生存。借助超声检查并对可疑病变进行穿刺活检早期发现分化型甲状腺癌、根治性手术以及对切除组织进行良好的组织学评估可确保获得非常好的治疗效果。
