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目的了解甲状腺乳头状微小癌患者生存现状。方法回顾性分析2002年1月1日-2011年12月31日期间在哈尔滨医科大学附属第二医院乳头状微小癌患者的生存情况,探讨影响其预后的相关因素。第二临床医学院普通外科接受治疗的158例甲状腺乳头状微小癌患者的临床资料和随访资料,对年龄、性别、10年生存率等进行Log-rank检验和COX模型多因素分析。结果 158例甲状腺乳头状微小癌患者10年生存率为91.84%。单因素分析提示首诊时年龄≥45岁、包膜浸润、有远处转移和手术方式显著影响甲状腺乳头状微小癌患者的预后(均P<0.05),而性别、BMI、原发癌灶大小、淋巴结是否转移、是否为术中偶然发现、是否为术后复发、是否I131治疗等与患者预后无显著相关;多元Cox比例风险回归发现患者年龄≥45岁、包膜浸润、有远处转移是影响甲状腺乳头状微小癌预后的独立因素(P<0.05)。方程受试者曲线下面积(ROC)为0.803,特异度为54.55%,灵敏度为98.67%(P<0.01)。结论甲状腺乳头状微小癌患者预后较好,但年龄≥45岁、包膜浸润和有远处转移者长期预后较差。
Objective To understand the status quo of patients with thyroid papillary microcarcinoma. Methods A retrospective analysis of January 1, 2002 - December 31, 2011 in Harbin Medical University Second Affiliated Hospital of patients with papillary microcarcinoma survival, and explore the impact of prognosis related factors. The clinical data and follow-up data of 158 cases of thyroid papillary micro-cancer who received general surgery in the Second Clinical Medical College were analyzed by Log-rank test and multivariate analysis of COX model. Results The 10-year survival rate of 158 cases of thyroid papillary microcarcinoma was 91.84%. Univariate analysis indicated that the prognosis of patients with thyroid papillary microcarcinoma (mean, P <0.05) was significantly different at the time of initial diagnosis of ≥45 years, infiltrating with envelope, distant metastasis and operation method, while the gender, BMI, , Lymph node metastasis, whether intraoperative accidental discovery, whether postoperative recurrence, whether I131 treatment and prognosis of patients was not significantly correlated; multiple Cox proportional hazards regression found that patients aged 45 years or more, infiltration of the envelope, with distant metastasis is The independent factors influencing the prognosis of papillary thyroid carcinoma (P <0.05). The area under the curve (ROC) was 0.803, the specificity was 54.55% and the sensitivity was 98.67% (P <0.01). Conclusions The prognosis of thyroid papillary microcarcinoma is good, but the long-term prognosis of patients with age≥45 years, envelopment and distant metastasis is poor.