索拉非尼治疗碘难治性分化型甲状腺癌的临床疗效  

Clinical efficacy of Sorafenib in iodine-refractory differentiated thyroid cancer

作　　者：董鹏 罗丽媛 陈杰 霍占江 DONG Peng;LUO Liyuan;CHEN Jie(Department of Otolaryngology and Head and Neck Surgery,Zhangjiakou First Hospital,Hebei,Zhangjiakou 075000,China;不详)

机构地区：[1]河北省张家口市第一医院耳鼻喉头颈外科,075000 [2]河北省张家口市第一医院呼吸与危重症医学二科,075000

出　　处：《河北医药》2025年第3期459-462,共4页Hebei Medical Journal

基　　金：张家口市重点研发计划项目(编号:2121060D)。

摘　　要：目的探讨索拉非尼治疗碘难治性分化型甲状腺癌(DTC)的临床疗效。方法选取2021年1月至2022年3月医院收治的90例碘难治性DTC患者,随机分为研究组和对照组,每组45例。对照组采用131 I治疗,研究组采用索拉非尼治疗,对研究组患者进行一般资料调查,并比较分析2组治疗效果和毒副反应发生状况。结果研究组患者中,预后良好37例(82.2%),预后不良8例(17.8%)。不同预后组患者在吸烟饮酒史、甲状腺球蛋白(TG)、甲状腺球蛋白抗(TG-Ab)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及血管内皮生长因子(VEGF)方面均差异有统计学意义(P<0.05);吸烟饮酒史、TG-Ab、NGAL及VEGF均为影响患者预后的独立危险因素(P<0.05);研究组治疗后TG、TG-Ab、NGAL及VEGF水平均较对照组低(P<0.05);2组毒副反应发生率无显著差异(P>0.05)。结论对碘难治性CTC患者采用索拉非尼治疗,其效果较好,且不会增加患者毒副反应,另外,吸烟饮酒史、TG-Ab、NGAL及VEGF指标,也会对患者预后产生重要影响,需引起临床工作者重视。Objective To investigate the clinical efficacy of Sorafenib in iodine-refractory differentiated thyroid cancer(DTC).Methods A total of 90 patients with iodine-refractory DTC admitted to the hospital from January 2021 to March 2022 were randomly divided into the study group(treated with Sorafenib)and the control group(treated with 131 I therapy).The general data of the patients in the study group were investigated,and the treatment effects and the occurrence of adverse effect were compared between the two groups.Results There were 37(82.2%)cases of good prognosis and 8(17.8%)cases of poor prognosis in the study group.There were significant differences in smoking and drinking history,thyroglobulin(Tg),thyroglobulin antibodies(Tg-Ab),neutrophil gelatinase-associated lipocalin(NGAL)and vascular endothelial growth factor(VEGF)between groups(P<0.05);smoking and drinking history,TG-Ab,NGAL and VEGF were all independent risk factors affecting the prognosis of patients(P<0.05).The levels of TG,TG-Ab,NGAL and VEGF in the study group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between groups(P>0.05).Conclusion Sorafenib has a good therapeutic effect on iodine-resistant DTC without increasing toxic side effects.In addition,clinicians should pay attention to the patient's smoking and drinking history,TG-Ab,NGAL and VEGF levels,as they have an important impact on the patient's prognosis.

关 键 词：碘难治性 分化型甲状腺癌 索拉非尼 治疗效果 影响因素 

分 类 号：R736.1[医药卫生—肿瘤]