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目的探讨甲状腺癌的临床病理特点和预后影响因素。方法选取2011年6月至2013年6月间收治并行手术治疗的甲状腺癌患者210例,分析患者的临床特点和治疗以及预后的主要影响因素。结果 210例甲状腺癌患者中,女性所占比率高于男性(男女之比为1∶1.9),差异有统计学意义(P<0.05)。≥45岁患者所占比例高于<45岁患者,差异有统计学意义(P<0.05)。67.6%的患者术前超声检出为甲状腺癌。病理类型主要为乳头状腺癌(73.8%)和滤泡状腺癌(26.2%),这两种类型均为分化型甲状腺癌。病理分期为Ⅰ~Ⅱ期113例(53.8%),Ⅲ~Ⅳ期97例(46.3%)。Logstic回归分析显示,临床分期(OR=4.445,P<0.05)、淋巴结转移(OR=3.213,P<0.05)、年龄(OR=2.001,P<0.05)、多中心癌灶(OR=1.567,P<0.05)为影响患者预后的独立危险因素。结论甲状腺癌以分化型病理类型为主,影响患者预后的因素较多,应根据患者的临床特征实施个体化的治疗方案。
Objective To investigate the clinicopathological features and prognostic factors of thyroid cancer. Methods A total of 210 patients with thyroid cancer undergoing concurrent surgery between June 2011 and June 2013 were selected to analyze the clinical features, treatment and prognostic factors of the patients. Results The proportion of women with thyroid cancer in 210 cases was higher than that of men (male to female ratio was 1: 1.9), the difference was statistically significant (P <0.05). The proportion of patients aged ≥45 years was higher than that of patients younger than 45 years (P <0.05). 67.6% of patients were diagnosed by thyroid cancer before surgery. Pathological types were papillary adenocarcinoma (73.8%) and follicular adenocarcinoma (26.2%), both of which were differentiated thyroid carcinomas. The pathological stage was stage Ⅰ ~ Ⅱ 113 cases (53.8%), stage Ⅲ ~ Ⅳ 97 cases (46.3%). Logistic regression analysis showed that the clinical stage (OR = 4.445, P <0.05), lymph node metastasis (OR = 3.213, P <0.05) <0.05) were independent risk factors affecting the prognosis of patients. Conclusions Thyroid cancer is mainly differentiated pathological type. There are many factors affecting the prognosis of patients with thyroid cancer. Individualized treatment regimens should be implemented according to the clinical characteristics of patients.