摘要
目的:探讨影响甲状腺乳头状癌预后的相关临床等因素。方法:选择该院1954年6月至1996年12月收治的1574例甲状腺乳头状癌患者,分析临床病理因素与预后的关系。根据COX回归模型的结果计算预后指数(prognostic index,PI),PI=β1x1+β2x2+···+βnxn(β1～-βn均为各变量回归系数,x1-xn为各变量等级值)。并根据PI值将患者分为不同的危险组,比较各组的生存率。结果:本组中位随访时间为16年。全组总的5、10、15、20年生存率分别为96.2%、92.1%、89.0%、86.2%。单因素分析显示,性别、有无淋巴结及远处转移、肿瘤大小、年龄、包膜侵犯情况、手术切除情况、临床分期与预后有关。多因素分析显示,性别、年龄、肿瘤大小、肿瘤侵犯程度、分期、淋巴结转移、远处转移是影响预后的重要因素。PI=0.056×(年龄)+0.402×(肿瘤侵犯程度)+0.062×(肿瘤大小)+0.224×(分期)+1.207×(远处转移)-0.589×(性别)。根据PI值将患者分为低危组(PI≤2.765),中危组(2.765<PI<5.152),高危组(PI≥5.152),低危组5、10、15、20年生存率为99.6%、98.3%、97.7%、95.1%;中危组5、10、15、20年生存率为95.5%、87.8%、84.7%、81.1%;高危组5、10、15、20年生存率为64.0%、49.5%、29.4%、19.3%。两两之间比较存在统计学差异(P=0.000)。结论:性别、年龄、肿瘤大小、肿瘤侵犯程度、分期、远处转移是影响甲状腺乳头状癌预后的重要因素。PI值可作为甲状腺乳头状癌患者预后的估计。
Objective： To investigate the clinical factors related to the prognosis of papillary thyroid carcinoma. Methods： The clinical materials and follow-up data of 1.574 cases with papillary thy- roid carcinoma seen in Tianjin Cancer Institute ＆ Hospital from June 1954 to December 1996 were analyzed retrospectively. The prognostic index （PI） of patients was calculated on the basis of the results of multivariate analysis. According to PI values, patients were classified into different hazard groups. Resuits： The 5-, 10-, 15-, and 20-year survival rates were 96%, 92%, 89%, and 86%, respectively. U- nivariate analysis showed thai gender, age, lymph node metastases, distant metastases, tumor size, ex- tent of tumor invasion, surgery modality, and clinical stage were associated with prognosis. Multivariate analysis showed that gender, age, tumor size, extent of tumor invasion, clinical stage, and distant metastases were prognostic factors. The patients were classified into low-risk, moderate-risk and highrisk groups according to the PI value. The 5-, 10-, 15-, and 20-year survival rate was 99.6%, 98.3%, 97.7%, and 95.1% in the low-risk group; 95.5%, 87.8%, 84.7%, and 81,1% in the moderate-risk group; and 64.0%, 49.5%, 29.4%, and 19.3% in the high-risk group. There was a significant difference among the groups （P〈0.05）. Conclusion： Gender, age, tumor size, extent of tumor invasion, clinical stage, and distant metastases are important prognostic factors in papillary thyroid carcinoma. Moreover, PI value can be used to develop a prognosis for patients with PTC.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2007年第22期1294-1297,共4页
Chinese Journal of Clinical Oncology
关键词
甲状腺乳头状癌
预后
生存率
预后指数
Papillary thyroid carcinoma Prognosis Survival rate Prognostic index
