94例甲状腺未分化癌临床分析  

Clinical and pathological analysis of patients with anaplastic thyroid carcinoma

作　　者：冯影[1] 高明[1] 

机构地区：[1]天津医科大学肿瘤医院甲状腺颈部肿瘤科,天津300060

出　　处：《天津医科大学学报》2008年第2期207-209,共3页Journal of Tianjin Medical University

摘　　要：目的:总结甲状腺未分化癌治疗经验,探讨其临床表现、诊断、治疗及预后影响因素。方法:回顾性分析94例甲状腺未分化癌患者的临床病理资料进行单因素(LogRank法)分析和多因素分析(COX比例模型),并复习相关文献。结果:94例患者,男39例,女55例;年龄22～77岁,中位年龄59.5岁;总的1、2、5年生存率分别为29.8%、23.4%和11.7%,中位生存时间为6个月;白细胞计数<10.0×109/L、就诊时肿物最大径<6cm、放疗治疗剂量≥4000cGy是影响预后的独立因素。Tb期患者手术治疗组预后好。结论:白细胞计数、放射治疗剂量、原发灶最大径是影响预后的独立因素;甲状腺未分化癌预后差,对患者积极进行综合治疗,尽可能彻底切除肿瘤,予剂量≥4000cGy的放疗,可予含紫杉醇的化疗。Objective： To explore clinical manifestations, diagnosis, treatment and factors that influence survival of the patients with anaplastic thyroid carcinoma（ATC） by summarizing the experience on treatment of anaplastic thyroid carcinoma. Methods： The clinical and pathological data of all patients with ATC were analyzed retrospectively, and motality and survival rate were observed （Log Rank）. Multivariate analysis was performed by the Cox proportional hazard model. Results：94 cases together were analyzed, including 39 males and 55 females.The median survival was 6 months and the 1-, 2-,and 5-year survival rates were 29.8%,23.4% and 11.7%,respectively. Univariate analysis showed the patients with white blood cell count〈 10.0×10^9/L, receiving radiotherapy ≥4 000 cGy, tumor size 〈6 cm, without distant metastasis had a better prognosis. According to multivariate analysis, white blood cell count, receiving radiotherapy ≥ 4 000 cGy, tumor size 〈6 cm were independent prognostic factors.Conclusion： White blood cell count at presentation, the dosage of radiotherapy and tumor size are factors independently influencing prognosis.The prognosis of anaplastic thyroid carcinoma is poor, complete surgical resection and postoperative radiotherapy ≥ 4 000 cGy is recommended, adjuvant chemotherapy including paclitaxel may be of help.

关 键 词：甲状腺肿瘤 治疗 预后 

分 类 号：R736.1[医药卫生—肿瘤]