分化型甲状腺癌远处转移131I治疗后疾病进展的影响因素  

Influential Factors of Disease Progression After 131I Treatment of Distant Metastasis of Differentiated Thyroid Cancer

作　　者：武新宇[1,2] 李博 闫新慧[1] 李夏黎[1] 高永举 樊锐太[3] WU Xinyu;LI Bo;YAN Xinhui;LI Xiali;GAO Yongju;FAN Ruitai(Department of Nuclear Medicine, Henan Provincial People’s Hospital,Zhengzhou 450003,China;Department of Radiation Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院核医学科,河南郑州450003 [2]郑州大学人民医院核医学科,河南郑州450003 [3]郑州大学第一附属医院放射治疗科,河南郑州450003

出　　处：《中国医学影像学杂志》2019年第5期374-378,384,共6页Chinese Journal of Medical Imaging

基　　金：国家临床重点专科建设项目(国卫办医函〔2013〕544号);河南省医学科技攻关计划项目(201403164)

摘　　要：目的筛选影响分化型甲状腺癌(DTC)远处转移^131I治疗后疾病进展的因素。资料与方法回顾性分析115例接受^131I治疗后DTC远处转移患者的临床资料。随访本组患者疾病无进展生存期,以转移灶最小时为观察起点,转移灶进展为观察终点,对比患者年龄、病理学类型、是否合并淋巴结转移、转移灶部位、转移灶大小、转移灶是否摄取^131I等影响因素。应用Kaplan-Meier勾画疾病无进展生存曲线,分别进行log-rank检验和Cox比例风险回归分析。结果本组患者平均随访时间(4.5±3.8)年,中位随访时间3.5年。随访期间疾病进展37例(32.17%)。多变量Cox比例风险回归分析结果显示,患者转移灶部位(RR=0.280,95%CI0.119~0.659,P=0.004)及^131I摄取情况(RR=2.189,95%CI1.048~4.571,P=0.037)与DTC患者远处转移的疾病进展有关。结论大部分DTC远处转移患者可通过规范治疗达到疾病无进展生存。转移灶部位及转移灶是否摄取^131I是影响DTC伴远处转移患者疾病进展独立影响因素。Purpose To analyze the progression-free survival after the ^131I treatment of distant metastasis of differentiated thyroid cancer (DTC), and to screen the factors influencing the disease progression. Materials and Methods A retrospective analysis was performed on the clinical data of 115 patients with DTC after 131I treatment of distant metastasis, and the patients in this group were followed up for the disease progression-free survival. Then the minimum metastasis was taken as the starting point of observation and the metastasis progression was taken as the end point of observation to compare the patient age, pathological type, whether accompanied by lymph node metastasis, metastasis site, metastasis size, whether metastasis uptake of ^131I and other influencing factors. Next, the disease progression-free survival curves were plotted by Kaplan-Meier to perform the log-rank test and Cox proportional risk regression analysis, respectively. Results The average follow-up time was (4.5±3.8) years (median 3.5 years) of the patients in this group, and during the follow-up, 37 patients (32.17%) had disease progression. The multivariate Cox proportional risk regression analysis showed that metastasis site (RR=0.280, 95% CI 0.119-0.659, P=0.004) and ^131I uptake (RR=2.189, 95% CI 1.048-4.571, P=0.037) were related to the disease progression of distant metastasis in DTC patients. Conclusion Most patients with DTC distant metastasis could achieve progression-free survival through standard treatment. The metastasis site and whether the metastasis uptake of ^131I are independent factors influencing the disease progression of patients with DTC distant metastasis.

关 键 词：甲状腺肿瘤 淋巴转移 碘放射性同位素 预后 

分 类 号：R445.3[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]