Jung Tae Sik, Kim Tae Yong, Kim Kyung Won, Oh Young Lyun, Park Do Joon, Cho Bo Youn, Shong Young Kee, Kim Won Bae, Park Young Joo, Jung Jung Hwa, Chung Jae Hoon
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Endocr J. 2007 Apr;54(2):265-74. doi: 10.1507/endocrj.k06-166. Epub 2007 Mar 20.
We performed this study to compare the clinicopathologic features and outcomes between the patients with poorly differentiated thyroid carcinoma (PDTC) and the patients with the aggressive variants of papillary thyroid carcinoma (PTC). To evaluate the prognostic factors for survival of the patients with PDTC, we selected 49 patients with PDTC and 23 patients with the aggressive variants of PTC from three hospitals during the recent 15 years. The five-year survival rate and clinicopathologic features of the patients with PDTC were not different from those of the patients with the aggressive variants of PTC. Univariate analysis revealed the significant poor prognostic factors for survival of the patients with PDTC and the aggressive variants of PTC as follows: 1) an age more than 45 years, 2) a tumor size larger than 4 cm, 3) the presence of tumor invasion to extrathyroidal tissue or the trachea, 4) the presence of cervical lymph node invasion, 5) the presence of distant metastasis, 6) the absence of high-dose radioactive iodine (RAI) therapy, and 7) TNM stage II, III and IV. Distant metastasis and high-dose RAI therapy were independent significant predictors for survival of the patients with PDTC and the aggressive variants of PTC on multivariate analysis. However, distant metastasis was the only independent significant predictors for survival of the patients with PDTC excluding patients with the aggressive variants of PTC.
我们开展这项研究以比较低分化甲状腺癌（PDTC）患者与甲状腺乳头状癌（PTC）侵袭性变异型患者的临床病理特征及预后。为评估PDTC患者生存的预后因素，我们在最近15年里从三家医院选取了49例PDTC患者和23例PTC侵袭性变异型患者。PDTC患者的五年生存率及临床病理特征与PTC侵袭性变异型患者并无差异。单因素分析显示，PDTC患者和PTC侵袭性变异型患者生存的显著不良预后因素如下：1）年龄超过45岁；2）肿瘤大小大于4 cm；3）存在肿瘤侵犯甲状腺外组织或气管；4）存在颈部淋巴结侵犯；5）存在远处转移；6）未进行高剂量放射性碘（RAI）治疗；7）TNM分期为II、III和IV期。多因素分析显示，远处转移和高剂量RAI治疗是PDTC患者和PTC侵袭性变异型患者生存的独立显著预测因素。然而，排除PTC侵袭性变异型患者后，远处转移是PDTC患者生存的唯一独立显著预测因素。
