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目的探讨影响晚期甲状腺癌预后的相关因素。方法1996年3月～2008年1月期间手术治疗为主的25例晚期甲状腺癌患者,术后随访,采用Kaplan-Meier法计算累积生存率,并在单因素分析基础上,进一步应用Cox回归模型进行预后的多因素分析。结果全组患者3年和5年生存率分别为86.4%、62.7%。单因素分析显示,年龄(P=0.0383)、周围解剖区域有无侵犯(P=0.0054)、临床分期(P=0.0033)、有无复发和转移(P=0.0041)以及术后是否坚持服用甲状腺素(P=0.0003)均为影响患者预后的相关危险因素,但多因素分析结果仅提示术后是否坚持服用甲状腺素(P=0.0076)是影响预后的独立因素。结论术后是否坚持服用甲状腺素对于晚期甲状腺癌患者预后有重要意义,应密切随访并督促其按时服药。
Objective To investigate the prognostic factors of advanced thyroid cancer. Methods From March 1996 to January 2008, 25 patients with advanced thyroid cancer undergoing surgery were followed up. The cumulative survival rate was calculated by Kaplan-Meier method. On the basis of univariate analysis, Cox regression model was further applied Multivariate analysis of prognosis. Results The 3-year and 5-year survival rates of the whole group were 86.4% and 62.7% respectively. Univariate analysis showed that age (P = 0.0383), invasion of surrounding anatomic area (P = 0.0054), clinical stage (P = 0.0033), recurrence and metastasis (P = 0.0041) (P = 0.0003) were the risk factors influencing the prognosis of patients. However, the results of multivariate analysis only suggested that whether to insist on taking thyroxine (P = 0.0076) after surgery was an independent prognostic factor. Conclusion Whether or not to insist on taking thyroxine after surgery is of great significance for the prognosis of patients with advanced thyroid cancer. Close follow-up and urging them to take medication on time should be done.