放射性^131I治疗分化型甲状腺癌肺转移的疗效及其主要预后因素的系统评价  

A systematic review of the effect of radioiodine-^131 in treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors

作　　者：牟达[1] 马晓娟[1] 李素平[1] 匡安仁[1] 

机构地区：[1]四川大学华西医院核医学科,成都610041

出　　处：《中华内分泌代谢杂志》2009年第3期250-254,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的对放射性^131I治疗分化型甲状腺癌肺转移的疗效及其主要预后因素进行系统评价。方法计算机检索了5个数据库，检出有关放射性^131I治疗分化型甲状腺癌肺转移疗效及其预后因素的文献，从中提取与^131I治疗及主要预后因素有关的患者的5年和（或）10年生存率，并用RevMan4．2软件进行统计分析。结果共纳入11个回顾性队列研究。统计分析结果提示：接受^131I治疗与未接受^131I治疗患者的5年生存率分别为74．9％和27．1％，二组患者的10年生存率分别为60．8％和12．2％，二者之间的差异有统计学意义（P〈0．01）；仅肺转移患者的5年及10年生存率均高于合并多处转移的患者（P〈0．01）；乳头状甲状腺癌患者的5年及10年生存率均高于滤泡状甲状腺癌患者的5年（P=0．01）及10年生存率（P=0．002）；男性与女性患者的5年及10年生存率没有差异（P〉0．05）。结论^131I治疗能明显提高分化型甲状腺癌肺转移患者的生存率；转移范围和组织学类型是分化型甲状腺癌肺转移患者的两个重要预后因素；患者的预后不受性别的影响。Objective To assess the effect of radioiodine-131 （^131 I ） on treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors. Methods Five databases were retrieved and all published studies which analyzed the effect of ^131I on pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors were systematically reviewed. The data about the impact of ^131I treatment and the main prognostic factors on the 5-yr and 10-yr survival rates of the patients were abstracted. RevMan 4.2 software was used to statistically analyze. Results Eleven retrospective cohort studies were included. The pooled results suggested that the 5-yr survival rates of the patients who received ^131 I therapy and who did not received ^131I therapy were 74.9% and 27.1% ,respectively;The 10-yr survival rates（ P〈0.01 ） of the two groups were 60.8% 和 12.2% , respectively;The difference between them had statistical significance （P〈0.01）. The 5-yr and 10-yr survival rates of the patients only with pulmonary metastases were higher than those of the patients with multiple metastases （ P〈0. 01 ）. The 5-yr （ P = 0. 01 ） and 10-yr （ P = 0. 002） surviv10al rates of the patients only with papillary thyroid carcinoma were higher than those of the patients with follicular thyroid carcinoma. The 5-yr and 10-yr survival rates of male and female patients were similar （ P 〉 0.05）. Conclusions ^131 I treatment increases the 5-yr and 10-yr survival rates of patients with pulmonary metastases from differentiated thyroid carcinoma. The extent of metastases and the histologic type of differentiated thyroid carcinoma are two main predicting factors of prognosis. The 5-yr and 10-yr survival rates of patients are not influenced by gender.

关 键 词：分化型甲状腺癌 肺转移 放射性^131I治疗 预后因素 

分 类 号：R736.1[医药卫生—肿瘤] R581.1[医药卫生—临床医学]