目的 探讨甲状腺乳头状癌术后复发的相关影响因素,为降低再手术风险及提高临床疗效提供依据。
方法 回顾性分析大连医科大学附属第二医院2005年1月至2008年12月期间收治的206例甲状腺乳头状癌患者的临床资料。本组患者均获访3~5年,平均4.1年,采用单因素及多因素分析方法对甲状腺乳头状癌术后复发与患者性别、年龄、肿瘤大小、甲状腺包膜有无浸润、淋巴结有无转移以及手术方式的相关性进行分析。
结果 206例甲状腺乳头状癌患者中,术后复发18例。单因素分析结果显示,术后复发与患者性别、肿瘤大小、甲状腺包膜是否被浸润、手术方式及淋巴结转移情况均有关(P<0.05);多因素分析结果显示,肿瘤大小、淋巴结转移情况及手术方式与甲状腺乳头状癌术后复发密切相关。
结论 肿瘤直径越大、有淋巴结转移和手术切除范围不足可能是甲状腺乳头状癌术后复发的高危因素。
Citation:
马振海,田晓峰,赵永福,邢光明,戴冬秋. Analysis of Factors Influencing The Postoperative Recurrence of Thyroid Papillary Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(12): 1410-1413. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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康维明, 朱长真, 田树波, 等. 甲状腺癌的外科治疗[J]. 中国医学科学院学报, 2013, 35(4):373-377.
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任国胜, 苏新良. 分化型甲状腺癌颈淋巴结清扫术式的选择[J]. 中国普外基础与临床杂志, 2010, 17(8): 765-767.
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Durante C, Montesano T, Torlontano M, et al. Papillary thyroid cancer:time course of recurrences during postsurgery surveillance[J]. J Clin Endocrinol Metab, 2013, 98(2):636-642.
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Cunningham MP, Duda RB, Recant W, et al. Survival discriminates for differentiated thyroid cancer[J]. AM J Surg, 1990, 160(4): 344-347.
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林益凯, 盛建明, 赵文和, 等. 多灶性甲状腺乳头状癌168例临床研究[J]. 中华外科杂志, 2009, 47(6): 450-453.
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Sanders LE, Silverman M. Follicular and Hürthle cell carcinoma:predicting outcome and directing therapy[J]. Surgery, 1998, 124(6): 967-974.
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Baek SK, Jung KY, Kang SM, et al. Clinical risk factors asso-ciated with cervical lymph node recurrence in papillary thyroid carcinoma[J]. Thyroid, 2010, 20(2): 147-152.
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ItoY, Kudo T, Kobayashi K, et al. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5 768 patients with average 10-year follow-up[J]. World J Surg, 2012, 36(6):1274-1278.
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Huang BY, Lin JD, Chao TC, et al. Therapeutic outcomes of papillary thyroid cancer patients in different risk groups[J]. Oncology, 2011, 80(1-2):123-129.
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范自平, 乔智, 吴德敬. 甲状腺癌诊断及复发因素分析[J]. 中国普外基础与临床杂志, 2010, 17(1): 68-72.
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de Meer SG, Dauwan M, de Keizer B, et al. Not the number but the location of lymph nodes matters for recurrence rate and disease-free survival in patients with differentiated thyroid cancer[J]. World J Surg, 2012, 36(6):1262-1267.
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吴延升, 张仑, 王旭东, 等. 甲状腺乳头状癌预后多因素分析[J]. 中国肿瘤临床, 2007, 34(22):1294-1297.
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Hiltzik D, Carlson DL, Tuttle RM, et al. Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients[J]. Cancer, 2006, 106 (6): 1286-1295.
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- 1. 康维明, 朱长真, 田树波, 等. 甲状腺癌的外科治疗[J]. 中国医学科学院学报, 2013, 35(4):373-377.
- 2. McLeod DS, Sawka AM, Cooper DS. Controversies in primary treatment of low-risk papillary thyroid cancer[J]. Lancet, 2013,381(9871):1046-1057.
- 3. Shaha AR. Recurrent differentiated thyroid cancer[J]. Endocr Pract, 2012, 18(4):600-603.
- 4. 任国胜, 苏新良. 分化型甲状腺癌颈淋巴结清扫术式的选择[J]. 中国普外基础与临床杂志, 2010, 17(8): 765-767.
- 5. 中华医学会内分泌学分会, 中华医学会外科学分会, 中国抗癌协会头颈肿瘤专业委员会, 等. 甲状腺结节和分化型甲状腺癌诊治指南[J]. 中国肿瘤临床, 2012, 39(17): 1249-1272.
- 6. Durante C, Montesano T, Torlontano M, et al. Papillary thyroid cancer:time course of recurrences during postsurgery surveillance[J]. J Clin Endocrinol Metab, 2013, 98(2):636-642.
- 7. Cunningham MP, Duda RB, Recant W, et al. Survival discriminates for differentiated thyroid cancer[J]. AM J Surg, 1990, 160(4): 344-347.
- 8. 林益凯, 盛建明, 赵文和, 等. 多灶性甲状腺乳头状癌168例临床研究[J]. 中华外科杂志, 2009, 47(6): 450-453.
- 9. Sanders LE, Silverman M. Follicular and Hürthle cell carcinoma:predicting outcome and directing therapy[J]. Surgery, 1998, 124(6): 967-974.
- 10. Baek SK, Jung KY, Kang SM, et al. Clinical risk factors asso-ciated with cervical lymph node recurrence in papillary thyroid carcinoma[J]. Thyroid, 2010, 20(2): 147-152.
- 11. ItoY, Kudo T, Kobayashi K, et al. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5 768 patients with average 10-year follow-up[J]. World J Surg, 2012, 36(6):1274-1278.
- 12. Huang BY, Lin JD, Chao TC, et al. Therapeutic outcomes of papillary thyroid cancer patients in different risk groups[J]. Oncology, 2011, 80(1-2):123-129.
- 13. 范自平, 乔智, 吴德敬. 甲状腺癌诊断及复发因素分析[J]. 中国普外基础与临床杂志, 2010, 17(1): 68-72.
- 14. de Meer SG, Dauwan M, de Keizer B, et al. Not the number but the location of lymph nodes matters for recurrence rate and disease-free survival in patients with differentiated thyroid cancer[J]. World J Surg, 2012, 36(6):1262-1267.
- 15. 吴延升, 张仑, 王旭东, 等. 甲状腺乳头状癌预后多因素分析[J]. 中国肿瘤临床, 2007, 34(22):1294-1297.
- 16. Hiltzik D, Carlson DL, Tuttle RM, et al. Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients[J]. Cancer, 2006, 106 (6): 1286-1295.