基于SEER数据库的甲状腺髓样癌预后分析  

Prognostic analysis of medullary thyroid carcinoma based on SEER data

作　　者：陈立 贾兰宁 王义增[1] 王钰云 段然 何向辉[1] CHEN Li;JIA Lan-ning;WANG Yi-zeng;WANG Yu-yun;DUAN Ran;HE Xiang-hui(Department of General Surgery,General Hospital,Tianjin Medical University,Tianjin Institute of General Surgery,Tianjin,300070 China)

机构地区：[1]天津医科大学总医院普通外科,天津普通外科研究所,天津300070

出　　处：《天津医科大学学报》2021年第2期167-171,共5页Journal of Tianjin Medical University

基　　金：国家自然科学基金(81672641)。

摘　　要：目的:探索影响甲状腺髓样癌的预后因素。方法:通过SEER*Stat软件收集SEER数据库中于2004—2015年行全甲状腺切除+淋巴结清扫,病理诊断明确提示为甲状腺髓样癌的867例患者,运用单因素与多因素Cox回归分析影响患者生存的独立因素,并分析独立危险因素的KM生存曲线。结果:纳入的867例患者平均随访时间60(29~94)个月,3年肿瘤特异性生存率96.1%,5年肿瘤特异性生存率95.1%,单因素Cox结果提示性别(HR=0.573,95%CI:0.337~0.973,P=0.039)、年龄(HR=3.12,95%CI:2.06~4.71,P<0.001)、肿瘤直径(HR=3.02,95%CI:2.10~4.34,P<0.001)、M分期(HR=12.9,95%CI:7.38~22.4,P<0.001)、阳性淋巴结数量(HR=2.07,95%CI:1.62~2.65,P<0.001)以及淋巴结阳性率(HR=3.00,95%CI:2.17~4.14,P<0.001)与患者生存时间有关,多因素Cox回归分析表明,年龄(HR=3.43,95%CI:2.23~5.27,P<0.001)、肿瘤直径(HR=1.96,95%CI:1.36~2.83,P<0.001)、M分期(HR=7.03,95%CI:3.82~12.9,P<0.001)和淋巴结阳性率(HR=2.24,95%CI:1.59~3.15,P<0.00)是行甲状腺全切+淋巴结清扫的MTC患者的独立危险因素。结论:诊断年龄、肿瘤直径、远处转移和淋巴结阳性率是影响甲状腺全切+淋巴结清扫术后的甲状腺髓样癌患者肿瘤特异性生存率的独立危险因素。Objective:To explore the prognostic factors affecting medullary thyroid carcinoma(MTC).Methods:SEER*Stat software was used to collect 867 patients with MTC from 2004 to 2015 who had total thyroidectomy and lymphadenectomy and whose pathological diagnosis was definite.Univariate and multivariate Cox regression was used to analyze the independent factors affecting the survival of patients,and to analyze the KM survival curve of independent risk factors.Results:The included 867 patients had an average follow-up time of 60(29-94)months,a 3-year tumor-specific survival rate of 96.1%,and a 5-year tumor-specific survival rate of 95.1%.Univariate Cox results suggested gender(HR=0.57,95%CI:0.337-0.973,P=0.039),age(HR=3.12,95%CI:2.06-4.71,P<0.001),tumor size(HR=3.02,95%CI:2.10-4.34,P<0.001),M stage(HR=12.9,95%CI:7.38-22.4,P<0.001)and lymph node ratio(LNR)(HR=3.00,95%CI:2.17-4.14,P<0.001)are related to the survival time of patients.Multivariate Cox regression analysis shows that age(HR=3.43,95%CI:2.23-5.27,P<0.001),tumor size(HR=1.96,95%CI:1.36-2.83,P<0.001),M stage(HR=7.03,95%CI:3.82-12.9,P<0.001),number of positive lymph nodes(HR=2.07,95%CI:1.62-2.65,P<0.001)and lymph node ratio(HR=2.24,95%CI:1.59-3.15,P<0.001)were independent risk factors for patients with MTC undergoing total thyroidectomy and lymph node dissection.Conclusion:Age,tumor size,M stage and LNR are independent risk factors that affect the survival of patients with MTC undergoing total thyroidectomy and lymph node dissection.

关 键 词：甲状腺髓样癌 SEER数据库 预后分析 COX回归 

分 类 号：R736.1[医药卫生—肿瘤]