甲状腺癌术后复发相关危险因素分析

摘要

目的 总结分析甲状腺癌术后复发的相关危险因素.方法 回顾性分析2004年1月至2014年1月行手术治疗的甲状腺癌患者145例临床资料,对其中术后甲状腺癌复发患者的资料与同期其他患者的临床资料进行对比,应用单因素和多因素非条件Logistic回归分析比较两组患者的性别、年龄、自身营养状况、TNM分期、术后是否正规放化疗、是否有淋巴结转移、手术方式、病理类型、术后是否出现并发症与甲状腺癌术后复发的相关强度,分析可能导致甲状腺癌术后复发的危险因素.结果 统计资料分析其中有29例患者术后出现甲状腺癌复发,单因素非条件Logistic回归分析显示:术前TNM分期为Ⅲ～Ⅳ期、术后正规放化疗、有淋巴结转移等危险因素比较差异有统计学意义(P＜ 0.05),年龄、性别、手术方式、病理类型、术后是否出现并发症与甲状腺癌术后复发无相关性(P＞0.05);多因素非条件Logistic回归分析显示:TNM分期中Ⅲ ～ Ⅳ期、术后正规放化疗、有淋巴结转移与甲状腺癌术后复发有显著相关性(P＜0.05);其余因素均无统计学意义.结论 甲状腺癌术后复发的原因复杂,其中与术前肿瘤TNM分期为Ⅲ-Ⅳ期、术后未行放化疗或者放化疗不正规、术前有淋巴结转移等关系密切.与患者的年龄、性别、手术方式、病理类型、术后是否出现并发症等未见明显相关性.%Objective To explore the risk factors of thyroid cancer recurrence.Methods Clinical data of 145 cases of thyroid cancer undergoing surgery from January 2004 to January 2014 were retrospectively analyzed.Clinical data of patients with and without thyroid cancer recurrence after surgery were compared.Compared sex,age,nutritional status,TNM stage,whether regular postoperative chemoradiotherapy,lymph node metastasis,surgical method,histological type,postoperative complications of two groups with single factor and multiple factors unconditioned Logistic regression analysis,analyzed risk factors of thyroid cancer recurrence.Results There were 29 cases of thyroid cancer recurrence.Single factor unconditioned Logistic regression analysis showed that:preoperative TNM stage Ⅲ-Ⅳ stage,regular postoperative chemoradiotherapy,lymph node metastasis had significant effect on thyroid cancer recurrence (P＜0.05),sex,age,surgical method,histological type,postoperative complications had no significant effect on thyroid cancer recurrence (P＞0.05).Multiple factors unconditioned Logistic regression analysis showed that:preoperative TNM stage Ⅲ-Ⅳ stage,regular postoperative chemoradiotherapy,lymph node metastasis had significant effect on thyroid cancer recurrence (P＜0.05).Conclusions The causes of thyroid cancer recurrence are complex,which is closely related to preoperative TNM stage Ⅲ-Ⅳ stage,regular postoperative chemoradiotherapy,preoperative lymph node metastasis,but not closely related to sex,age,surgical method,histological type,postoperative complications.