Wan Zheng, Wang Bing, Yao Jing, Li Qing, Miao Xin, Jian Yanbing, Huang Sisi, Lai Shengwei, Li Chen, Tian Wen
Department of Thyroid & Hernia Surgery, Medical Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China.
Front Oncol. 2023 Jul 7;13:1102936. doi: 10.3389/fonc.2023.1102936. eCollection 2023.
To elucidate the clinicopathological characteristics and prognostic factors of poorly differentiated thyroid carcinoma.
A total of 24912 thyroid carcinoma patients admitted to the First Medical Center of Chinese People's Liberation Army General Hospital from 2005 to 2020 were retrospectively reviewed. A total of 94 patients (39 males and 55 females, a male-female ratio of 1:1.4) fulfilled the selection criteria. Of these, 73 patients had undergone surgery. The clinical and pathological data were collected from each enrolled patient. Univariate and multivariate Cox regression analyses were performed to determine independent prognostic factors. All analyses were performed with the SPSS version 26.0 and R version 1.2.5033 in the R Studio environment.
The specimens included 20 cases of poorly differentiated thyroid carcinoma complicated with papillary thyroid carcinoma, 17 cases complicated with follicular thyroid carcinoma, 34 cases complicated with other pathological types and 23 with a separate entity. The patient demonstrated a large age span, median age was 57 years (range 8-85 years, average 55.20 ± 15.74 years). The survival time of the 94 cases was calculated, and the mean Overall survival time was 33 (range, 1-170) months, and the mean Recurrence-free survival time was 14 (range, 1-90) months. Recurrence-free mortality is related to the age at diagnosis, extrathyroidal extension and Associated thyroid cancer (p<0.05). In contrast, overall mortality is related to the age at diagnosis, sex, extrathyroidal extension, T stage (AJCC 8th), surgery and radiation (p<0.05).
Middle-aged and elderly patients are still at high risk for poorly differentiated thyroid carcinoma. The pathologic results of poorly differentiated thyroid carcinoma are varied, and reasonable treatment has an important impact on the prognosis of poorly differentiated thyroid carcinoma.
阐明低分化甲状腺癌的临床病理特征及预后因素。
回顾性分析2005年至2020年在中国人民解放军总医院第一医学中心收治的24912例甲状腺癌患者。共有94例患者（男性39例，女性55例，男女比例为1:1.4）符合入选标准。其中，73例患者接受了手术。收集每位入选患者的临床和病理数据。进行单因素和多因素Cox回归分析以确定独立预后因素。所有分析均在R Studio环境中使用SPSS 26.0版和R 1.2.5033版进行。
标本包括20例低分化甲状腺癌合并乳头状甲状腺癌、17例合并滤泡状甲状腺癌、34例合并其他病理类型以及23例为单一病理类型。患者年龄跨度大，中位年龄为57岁（范围8 - 85岁，平均55.20±15.74岁）。计算了94例患者的生存时间，平均总生存时间为33个月（范围1 - 170个月），平均无复发生存时间为14个月（范围1 - 90个月）。无复发生存率与诊断时年龄、甲状腺外侵犯及相关甲状腺癌有关（p<0.05）。相比之下，总死亡率与诊断时年龄、性别、甲状腺外侵犯、T分期（AJCC第8版）、手术及放疗有关（p<0.05）。
中老年患者仍是低分化甲状腺癌的高危人群。低分化甲状腺癌的病理结果多样，合理治疗对低分化甲状腺癌的预后有重要影响。
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