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目的探讨甲状腺乳头状腺癌(pap illary thyroid carc inom a,PTC)侵犯气管的治疗方式及其预后。方法回顾性分析1980—1995年间45例PTC侵犯气管患者的临床资料。根据肿瘤侵犯气管的范围和程度不同分为气管局限性受侵组(A组)行肿瘤切除术28例,肿瘤侵及气管腔内组(B组)行根治性切除术10例和肿瘤区域广泛受侵组(C组)行姑息性切除术7例。39例行颈淋巴清扫术。术后切缘病理检查有肿瘤细胞或术中肉眼观察肿瘤切除不干净的部分患者给予术后放疗,共17例。Kap lan-M e ier法计算累积生存率,组间差异采用Log-Rank法检验。结果①A组5年和10年生存率分别为85.0%和62.6%。7例术后放疗,21例术后未放疗。术后放疗与术后未放疗比较,5年和10年生存率比较差异均无统计学意义(P值均>0.05)。②B组5年和10年生存率分别为80.0%和58.3%。术后放疗6例,未放疗4例。术后放疗与否,5年和10年生存率比较差异均无统计学意义(P值均>0.05)。③C组5年和10年生存率分别为42.9%和28.6%。4例术后放疗患者,5年和10年生存率分别为50.0%和50.0%。3例术后未放疗患者,5年生存率为33.3%,无10年生存。术后放疗与否,其5年和10年生存率比较差异均无统计学意义(P值均>0.05)。结论PTC气管受侵尚未侵及腔内黏膜层者可采用肿瘤切除术得以根治,穿透气管腔内黏膜层者行肿瘤根治性切除可延长患者的生存。术后放疗有可能提高姑息性切除患者的生存率。
Objective To investigate the treatment and prognosis of trachea with papillary thyroid carciona (PTC) invading the trachea. Methods The clinical data of 45 PTC patients with tracheal invasion from 1980 to 1995 were retrospectively analyzed. According to the extent and extent of tumor invasion of trachea, trachea was divided into two groups: group A (28 cases), group B (tumor invasion and group B), radical resection and extensive tumor area Invasive group (C group) palliative resection in 7 cases. 39 cases of cervical lymphadenectomy. Postoperative margins of the pathological examination of tumor cells or intraoperative visual observation of tumor removal was not clean in some patients given postoperative radiotherapy, a total of 17 cases. Kaplan-Meier method to calculate the cumulative survival rate, the difference between groups using Log-Rank test. Results The 5-year and 10-year survival rates in group A were 85.0% and 62.6% respectively. 7 cases of postoperative radiotherapy, 21 cases of postoperative radiotherapy. There was no significant difference in the 5-year and 10-year survival rates between postoperative radiotherapy and postoperative radiotherapy (P> 0.05). ② The 5-year and 10-year survival rates of group B were 80.0% and 58.3% respectively. Postoperative radiotherapy in 6 cases, 4 cases without radiotherapy. Postoperative radiotherapy or not, 5-year and 10-year survival rates were no significant difference (P> 0.05). The 5-year and 10-year survival rates in group C were 42.9% and 28.6% respectively. Four patients with postoperative radiotherapy, 5-year and 10-year survival rates were 50.0% and 50.0%. Three patients who did not radiotherapy had a 5-year survival rate of 33.3% and no 10-year survival. Postoperative radiotherapy or not, the 5-year and 10-year survival rates were no significant difference (P> 0.05). Conclusion PTC tracheal invasion has not yet invading the intraluminal mucosa can be cured by tumor resection, and tracheal endothelium through the mucosa in patients with radical resection of the tumor can extend the survival of patients. Postoperative radiotherapy may improve the survival of palliative resection patients.