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甲状腺原发性和继发性鳞状细胞癌分析:一项回顾性研究。

Analysis of primary and secondary squamous cell carcinoma of the thyroid gland: a retrospective study.

作者信息

Liu Gang, Xu Xiequn, Chen Ge, Liu Ziwen

机构信息

Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Department of Breast Surgical Oncology, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Gland Surg. 2021 Feb;10(2):559-566. doi: 10.21037/gs-20-628.

Abstract

BACKGROUND

Squamous cell carcinoma of the thyroid (SCCT) is a kind of rare malignant disease. This study aimed to analyse the clinical characteristics of patients with primary SCCT (PSCCT) and secondary SCCT (SSCCT).

METHODS

The medical records of seventeen patients with PSCCT and six patients with SSCCT were reviewed. Clinical symptoms, ultrasound, and pathological characteristics were compared between the two groups.

RESULTS

The mean age of diagnosis was approximately 56 years old in each group. The most common chief complaint of the patients was neck mass in both groups. The percentage of patients with cough (P=0.008) or weight loss (P=0.021) was higher in the SSCCT group than the PSCCT group. The mean size of the tumor in the PSCCT group was larger than that in the SSCCT group (3.382±2.011 1.950±0.794 cm, P=0.024). Papillary thyroid carcinoma (PTC) could be combined with or recur as PSCCT. Kaplan-Meier analysis indicated that the mean survival times after diagnosis were 17.053 months in the PSCCT patients and 13.500 months in the SSCCT patients. Multivariate survival analysis using a Cox regression model demonstrated that predictors of overall survival (OS) in PSCCT patients included age (P=0.020), enlarged cervical lymph node (P=0.017), radical operation (P=4.82×10), and PTC (P=0.03).

CONCLUSIONS

SCCT is aggressive, with neck mass being the most common chief complaint. There were several different characteristics between PSCCT and SSCCT. PTC could be combined with or recur as PSCCT. Age, enlarged cervical lymph node, radical operation, and PTC were the predictors of OS in PSCCT patients.

摘要

背景

甲状腺鳞状细胞癌(SCCT)是一种罕见的恶性疾病。本研究旨在分析原发性甲状腺鳞状细胞癌(PSCCT)和继发性甲状腺鳞状细胞癌(SSCCT)患者的临床特征。

方法

回顾了17例PSCCT患者和6例SSCCT患者的病历。比较两组患者的临床症状、超声及病理特征。

结果

每组患者的平均诊断年龄约为56岁。两组患者最常见的主要症状均为颈部肿块。SSCCT组咳嗽(P = 0.008)或体重减轻(P = 0.021)的患者比例高于PSCCT组。PSCCT组肿瘤的平均大小大于SSCCT组(3.382±2.011对1.950±0.794 cm,P = 0.024)。甲状腺乳头状癌(PTC)可合并PSCCT或复发为PSCCT。Kaplan-Meier分析表明,PSCCT患者诊断后的平均生存时间为17.053个月,SSCCT患者为13.500个月。使用Cox回归模型进行的多因素生存分析表明,PSCCT患者总生存(OS)的预测因素包括年龄(P = 0.020)、颈部淋巴结肿大(P = 0.017)、根治性手术(P = 4.82×10)和PTC(P = 0.03)。

结论

SCCT具有侵袭性,颈部肿块是最常见的主要症状。PSCCT和SSCCT之间存在一些不同特征。PTC可合并PSCCT或复发为PSCCT。年龄、颈部淋巴结肿大、根治性手术和PTC是PSCCT患者OS的预测因素。

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