老年甲状腺癌175例临床特点及预后分析

Clinical characteristics and prognosis of elderly patients with thyroid carcinoma: 175 cases report

关键词:  甲状腺癌  老年  预后  分化型癌  未分化癌

Key words:  [Key words]　thyroid carcinoma  elder  prognosis  differentiated carcinoma  undifferentiated carcinoma

摘要:

目的　探讨老年甲状腺癌患者的临床病理学特点及影响预后的相关因素。　方法　　收集天津市肿瘤医院及吉林辽源市中心医院1991年1月—2002年12月收治的175例老年甲状腺癌患者的临床资料，肿瘤位于单侧152例，双侧23例。所有病例均行手术治疗，分析临床病理学特点及与预后的关系。　结果　　（1）老年甲状腺癌患者病例中，未分化癌所占比例较高（5.1%），中晚期（Ⅲ期、Ⅳ期）患者比例高(54.9%)，远处转移率（6.3%）及局部侵犯率（18.3%）较高；（2）全组患者总的5、10年生存率分别为83.8%、67.9%。病理分期、远处转移、病理类型及是否周围组织侵犯是影响预后的重要因素，差异具有显著性意义（P<0.05），而性别、淋巴结转移、肿瘤大小等与预后无关。　结论　　老年甲状腺癌患者存在病理分型较差、分期较晚、局部侵犯率及远处转移率较高等预后不良因素。

Abstract:

[Abstract] Objective 　To explore the clinical characteristics and prognosis of elderly patients with thyroid carcinoma. 　Methods The clinical materials and follow- up data of 175 cases of elderly thyroid carcinoma patients hospitalized in Tianjin Cancer Hospital and Liaoyuan Central Hospital from January 1991 to December 2002 were analyzed retrospectively. 　Results In cases of elderly patients with thyroid cancer, undifferentiated carcinoma (5.1%) and advanced (stage III,IV) patients (54.9%) accounted for a higher proportion, the distant metastasis rate (6.3%) and local invasion rate (18.3%) was higher. Total 5, 10 year survival rate were 83.8%, 67.9% respectively. Univariate analysis showed that stage, metastasis, pathological type and extent of tumor invasion were significantly associated with prognosis, while sex, lymph node metastasis and tumor size were no significantly associated with prognosis. 　Conclusion Elderly thyroid carcinoma patients have poor factors of highly aggressive Pathological classification, advanced stage, high local invasion and distant metastasis rate which indicate poor prognosis.