分化型甲状腺癌经腔镜手术治疗后出现复发转移的危险因素分析  

Analysis of Risk Factors for Recurrence and Metastasis of Differentiated Thyroid Carcinoma After Endoscopic Surgery

作　　者：成志烜 CHENG Zhixuan(Department of Thyroid and Breast Surgery,Wanzai County People's Hospital,Wanzai 336199,Jiangxi,China)

机构地区：[1]万载县人民医院甲乳外科,江西万载336199

出　　处：《医学信息》2024年第19期94-97,共4页Journal of Medical Information

摘　　要：目的 分析分化型甲状腺癌(DTC)经腔镜手术治疗后出现复发转移的危险因素。方法 以2019年12月-2021年12月万载县人民医院行腔镜手术治疗的112例DTC患者为研究对象。截至2023年9月,其术后复发转移者共32例,设为复发转移组,未复发转移者共80例,设为未复发转移组,收集其基线资料,通过单因素及多因素Logistic分析DTC经腔镜手术治疗后出现复发转移的危险因素。结果 复发转移组与未复发转移组年龄、病理类型、肿瘤直径、临床分期、术前淋巴结转移、病灶数目、术后口服甲状腺素比较,差异有统计学意义(P<0.05),其中复发转移组年龄≥45岁、肿瘤类型FTC、肿瘤直径≥5 cm、临床分期Ⅲ~Ⅳ期、术前淋巴结转移、多发病灶、术后未口服甲状腺素患者占比高于未复发转移组。经Logistic回归分析显示,年龄≥45岁(OR:2.932,95%CI:1.208~4.217)、肿瘤直径≥5 cm (OR:2.653,95%CI:1.054~3.435)、临床分期Ⅲ~Ⅳ期(OR:2.134,95%CI:1.129~3.741)、术前淋巴结转移(OR:2.241,95%CI:1.632~4.063)、多发病灶(OR:2.173,95%CI:1.339~3.648)是DTC患者经腔镜手术治疗后出现复发转移的独立危险因素(P<0.05)。结论 DTC患者经腔镜手术治疗后发生复发转移与年龄、肿瘤直径、临床分期、术前淋巴结转移、多发病灶密切相关。Objective To analyze the risk factors of recurrence and metastasis of differentiated thyroid carcinoma(DTC)after endoscopic surgery.Methods A total of 112 patients with DTC who underwent endoscopic surgery in Wanzai County People's Hospital from December 2019 to December 2021 were enrolled in the study.As of September 2023,a total of 32 patients with postoperative recurrence and metastasis were set as recurrence and metastasis group,and a total of 80 patients without recurrence and metastasis were set as non-recurrence and metastasis group.The baseline data were collected,and the risk factors of recurrence and metastasis of DTC after endoscopic surgery were analyzed by univariate and multivariate Logistic analysis.Results There were statistically significant differences in age,pathological type,tumor diameter,clinical stage,preoperative lymph node metastasis,number of lesions,and postoperative oral thyroxine between the recurrence and metastasis group and the non-recurrence and metastasis group(P<0.05),while the proportion of patients with age≥45 years old,tumor type FTC,tumor diameter≥5 cm,clinical stageⅢ-Ⅳ,preoperative lymph node metastasis,multiple lesions,and postoperative non-oral thyroxine in the recurrence and metastasis group was higher than that in the non-recurrence and metastasis group.Logistic regression analysis showed that age≥45 years old(OR:2.932,95%CI:1.208-4.217),tumor diameter≥5 cm(OR:2.653,95%CI:1.054-3.435),clinical stageⅢ-Ⅳ(OR:2.134,95%CI:1.129-3.741),preoperative lymph node metastasis(OR:2.241,95%CI:1.632-4.063),multiple lesions(OR:2.173,95%CI:1.339-3.648)were independent risk factors for recurrence and metastasis in DTC patients after endoscopic surgery(P<0.05).Conclusion Recurrence and metastasis of DTC patients after endoscopic surgery are closely related to age,tumor diameter,clinical stage,preoperative lymph node metastasis and multiple lesions.

关 键 词：分化型甲状腺癌 腔镜手术 复发转移 滤泡状甲状腺癌 术前淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]