[119例滤泡性甲状腺癌患者的管理与预后因素]
[Management and prognostic factors for 119 patients with follicular thyroid carcinoma].
作者信息
Liu Wen-sheng, Zhang Guo-fen, Xu Zhen-gang
机构信息
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. Email:
出版信息
Zhonghua Zhong Liu Za Zhi. 2013 Oct;35(10):778-82.
OBJECTIVE
To explore the optimal management and analyze the prognostic factors for follicular thyroid carcinoma.
METHODS
The clinicopathological data of 119 patients with well-differentiated follicular thyroid carcinoma treated in our hospital from 1970 to 2008 were retrospectively reviewed. The overall survival (OS) rate was estimated by Kaplan-Meier method. Log rank and Cox regression analyses were used to identify the prognostic factors.
RESULTS
The 5- and 10-year OS rates were 81.1% and 66.7%, respectively. The 3- , 5- and 10-year cumulative distant metastasis rates were 27.4%, 29.6% and 35.9%, respectively. The age of ≥ 45 years old was one of the most important factors affecting survival rate (P < 0.05) and an independent factor for distant matastasis.
CONCLUSIONS
Follicular thyroid carcinoma has some special features such as diffuse growth and vascular tumors thrombosis and with a relatively poor prognosis. The key measure to improve local control and prognosis is radical resection. Some aggressive management such as total thyroidectomy combined with (13)1I therapy and regular follow-up should be performed to improve the survival rate and to control postoperative distant metastasis for patients ≥ 45 years old.
目的
探讨滤泡状甲状腺癌的最佳治疗方法并分析其预后因素。
方法
回顾性分析我院1970年至2008年收治的119例分化型滤泡状甲状腺癌患者的临床病理资料。采用Kaplan-Meier法估计总生存率（OS）。采用对数秩检验和Cox回归分析确定预后因素。
结果
5年和10年总生存率分别为81.1%和66.7%。3年、5年和10年累积远处转移率分别为27.4%、29.6%和35.9%。年龄≥45岁是影响生存率的最重要因素之一（P<0.05），也是远处转移的独立因素。
结论
滤泡状甲状腺癌具有弥漫性生长、血管肿瘤血栓形成等特点，预后相对较差。提高局部控制率和预后的关键措施是根治性切除。对于≥45岁的患者，应采取一些积极的治疗措施，如全甲状腺切除术联合碘-131治疗及定期随访，以提高生存率并控制术后远处转移。
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