老年分化型甲状腺癌肺转移危险因素分析  

Analysis of Risk Factors of Lung Metastasis in Elderly Patients with Differentiated Thyroid Carcinoma

作　　者：刘良森[1] 韦智晓[1] 李俊红[1] 彭盛梅[1] 田甜[1] 张筱楠[1] 

机构地区：[1]广西医科大学第一附属医院核医学科,广西南宁530021

出　　处：《标记免疫分析与临床》2016年第5期495-497,542,共4页Labeled Immunoassays and Clinical Medicine

基　　金：广西壮族自治区科技厅项目(桂科攻0861003)

摘　　要：目的探讨老年分化型甲状腺癌(DTC)发生肺转移的危险因素。方法回顾性分析72例年龄≥60岁DTC患者的临床资料。通过甲状腺球蛋白水平、^(131)I全身显像、胸部平片、胸部CT或肺部病灶病理确诊肺转移。对性别、年龄、病理类型、肿瘤大小、病灶数量、甲状腺包膜侵犯、颈淋巴结转移7个因素进行单因素和多因素分析,寻找影响老年DTC发生肺转移的危险因素。结果 72例老年DTC中,肺转移率为27.8%。单因素分析结果显示:甲状腺滤泡状癌、肿瘤直径≥4cm、甲状腺包膜侵犯、颈淋巴结转移是预测肺转移的显著性因素(P<0.05)。多因素Logistics回归分析结果显示,滤泡状癌、肿瘤直径≥4cm、甲状腺包膜侵犯、颈淋巴结转移是老年DTC肺转移的独立危险因素(P<0.05)。结论老年DTC肺转移发生率较高。肺转移与多种临床病理因素相关,滤泡状癌、肿瘤直径≥4cm、甲状腺包膜侵犯、颈淋巴结转移的患者更容易发生肺转移,应加强对这类患者的治疗与随访。Objective To investigate risk factors of lung metastasis in elderly patients with differentiated thyroid carcinoma（DTC）.Methods The clinical data of seventy-two elderly（age ≥60 years） patients with DTC were analyzed retrospectively.Diagnosis of pulmonary metastasis was determined by thyroglobulin level,131 I whole body scan,X-ray or lung CT imaging and pathology of lung lesions.Seven relevant risk factors of lung metastasis included age,gender,pathological type,tumor size,number of tumor foci,capsular invasion and cervical lymph node metastasis.Univariate and multivariate analysis were performed.Results A total of72 elderly DTC cases was included,27.8% suffered from lung metastasis.Univariate analysis showed that follicular histology,tumor size ≥ 4 cm,capsular invasion and cervical lymph node metastasis were significantly associated with lung metastasis（all P〈0.05）.M ultivariate logistic regression analysis showed that risk factors of lung metastasis included follicular histology,tumor size ≥ 4 cm,capsular invasion and cervical lymph node metastasis（all P〈0.05）.Conclusion Elderly patients with DTC have a considerably higher incidence of lung metastasis.The elderly patients with follicular histology,tumor size≥4cm,capsular invasion and cervical lymph node metastasis were more likely to have lung metastasis.

关 键 词：分化型甲状腺癌 肺转移 老年 危险因素 

分 类 号：R736.1[医药卫生—肿瘤]