分化型甲状腺癌患者术后^(131)I清除残余甲状腺组织的疗效及影响因素  

Clinical efficacy and risk factors of ^(131)I treatment for thyroid remnant ablation in patients with differentiated thyroid cancer after operation

作　　者：梁坤[1] 李诗运[1] 戴儒奇[1] 

机构地区：[1]海南省人民医院核医学科,海南海口570311

出　　处：《海南医学》2018年第3期339-342,共4页Hainan Medical Journal

基　　金：海南省自然科学基金(编号:806117)

摘　　要：目的评价分化型甲状腺癌(DTC)患者术后^(131)I清除残余甲状腺组织(简称"清甲")的疗效,并分析影响治疗效果的因素。方法回顾性分析2010年1月至2016年4月在海南省人民医院接受^(131)I治疗的290例行全切或次全切的DTC患者的临床资料,所有患者均行^(131)I影像学检查,24 h摄^(131)I率评价疗效,并采用Logistic回归分析疗效的影响因素。结果 290例患者,^(131)I清甲成功率为60.69%(176/290)。单因素分析结果显示,残余甲状腺质量、肿瘤是否转移、TSH水平、24 h摄^(131)I率、^(131)I剂量是影响^(131)I疗效的因素(P<0.05)。多因素Logistic回归分析结果显示,残余甲状腺质量(OR=1.578,95%CI:1.167~2.793),肿瘤是否转移(OR=2.115,95%CI:1.414~3.285)是影响^(131)I清甲成功与否的独立危险因素。结论^(131)I治疗DTC术后残余甲状腺组织成功率较高,残余甲状腺质量和肿瘤是否转移是影响^(131)I清甲成功与否的独立危险因素。Objective To evaluate the clinical efficacy and analyze the risk factors of 131I treatment for thyroidremnant ablation in patients with differentiated thyroid cancer （DTC） after operation. Methods A retrospective analysis wasmade among 290 patients with DTC in Hainan General Hospital undergoing operation and 131I treatment after operation fromJanuary 2010 to April 2016. The effect of 131I treatment for thyroid remnant ablation was evaluated with 131I imaging examina-tion and 131I absorb rate within 24 hours. The factors influencing the therapeutic effects were also analyzed using logistic re-gression analysis. Results Among 290 patients, thyroid remnant ablation was achieved in 60.69% of patients. Univariatefactor analysis showed that thyroid remnant weight, metastasis, TSH level, 131I uptake rate within 24 hours, and dose of 131Iwere correlated with clinical effects （P〈0.05）. Multivariate logistic regression analysis showed that the thyroid remnantweight （OR=1.578, 95%CI： 1.167-2.793）, metastasis （OR=2.115, 95%CI： 1.414-3.285） were independent risk factors affect-ing treatment for thyroid remnant ablation. Conclusion 131I treatment for thyroid remnant ablation in DTC patients is effec-tive. And thyroid remnant weight, metastasis are the factors to influence the effects of treatment for thyroid remnant abla-tion in patients with DTC after operation.

关 键 词：分化型甲状腺癌 清除残余甲状腺组织 疗效 影响因素 131I 

分 类 号：R736.1[医药卫生—肿瘤]