远处转移分化型甲状腺癌发生放射性碘治疗耐受的危险因素及预测指标分析  

Risk factors and predictive indexes of radioactive iodine refractory in distant metastatic differentiated thyroid cancer

作　　者：查清[1] ZHA Qing(Department of Nuclear Medicine,Naval Anqing Hospital,Anqing 246003,Anhui,China)

机构地区：[1]海军安庆医院核医学科,安徽安庆246003

出　　处：《川北医学院学报》2021年第4期497-500,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨远处转移分化型甲状腺癌(DTC)发生放射性碘治疗耐受(RAIR)的危险因素及预测指标分析。方法:将181例远处转移DTC患者分为碘难治组(RAIR组,n=61)及碘治疗有效组(RAIE组,n=120)。比较两组的临床资料及血清学指标,探究远处转移DTC发生RAIR及血清甲状腺球蛋白(Tg)的预测效能。结果:单因素分析显示,两组患者性别、远处转移部位、病灶为单侧或双侧、颈部淋巴结转移数量、是否纵膈淋巴结转移、是否伴发良性甲状腺疾病比较,差异无统计学意义(P>0.05);两组年龄、病理类型及治疗前血清Tg水平比较,差异有统计学意义(P<0.05)。多因素分析显示,年龄>45岁、病理类型为滤泡型甲状腺癌(FTC)、治疗前血清Tg水平>46.860μg/L为远处转移DTC发生RAIR的独立危险因素;治疗前血清Tg预测远处转移DTC发生RAIR的AUC为0.831。经过131 I治疗后,RAIR组的血清Tg升高,而RAIE组血清Tg下降(P<0.05)。结论:年龄较大、滤泡型甲状腺癌及高血清Tg是远处转移DTC发生RAIR的独立危险因素,及时识别RAIR-DTC能为患者治疗方案选择提供依据。Objective:To explore the risk factors and predictive indexes of radioactive iodine refractory(RAIR)in distant metastatic differentiated thyroid cancer(DTC).Methods:A total of 181 patients with distant metastatic DTC were divided into radioactive iodine refractory group(RAIR group,n=61)and radioactive iodine efficient group(RAIE group,n=120).The clinical data and serological indexes were compared between the two groups.The occurrence of RAIR and predictive efficiency of serum thyroglobulin(Tg)were explored.Results:Univariate analysis showed that there were no significant differences between the two groups in gender,distant metastasis sites,unilateral or bilateral lesions,number of cervical lymph node metastases,mediastinal lymph node metastasis and benign thyroid diseases(P>0.05),while there were significant differences in age,pathological types and level of serum Tg before treatment(P<0.05).Multivariate analysis showed that age older than 45 years old,pathological type of FTC and level of serum Tg before treatment higher than 46.860μg/L were independent risk factor of RAIR in distant metastatic DTC.AUC of serum Tg before treatment for predicting RAIR was 0.831.After 131 I treatment,level of serum Tg in RAIR group was increased,while which was decreased in RAIE group(P<0.05).Conclusion:Older age,follicular thyroid cancer and high serum Tg are independent risk factor of RAIR in distant metastatic DTC.Timely identification of RAIR-DTC can provide basis for selection of treatment plans.

关 键 词：甲状腺癌 放射性碘治疗耐受 危险因素 甲状腺球蛋白 

分 类 号：R453.9[医药卫生—治疗学]