放射性碘-131治疗分化型甲状腺癌转移灶的疗效及其影响因素

Clinical efficacy and risk factors of 131I treatment for differentiated thyroid cancer with metastasis

目的评价放射性碘-131（131I）治疗分化型甲状腺癌（DTC）转移灶的疗效，并分析影响其疗效的相关因素。方法回顾性分析接受131I治疗并出现转移的204例DTC患者的临床资料，所有患者均行131I影像学检查、血清甲状腺球蛋白（Tg）检测评价疗效，并采用Logistic回归分析影响疗效的因素。结果204例患者中治愈占22．5％，好转或稳定占60．8％。单因素分析结果显示，年龄、转移部位、平均服碘剂量、治疗前促甲状腺激素（TSH）水平和瞻水平与”。I治疗甲状腺癌转移灶疗效存在相关性（P〈0．05）。Logistic回归分析结果显示，年龄（OR=7．01，95％CI5．57～9．46）、TSH水平（OR=0．38，95％C10．14～0．77）、治疗前Tg水平（OR=1．25，95％CI1．01～1．82）及转移部位（OR=3．12，95％CI1．14～5．67）是131I治疗甲状腺癌转移灶疗效的影响因素。结论131I治疗分化型甲状腺癌转移灶安全有效；年龄、治疗前Tg水平、TSH水平、是否出现淋巴结远处转移是影响131I治疗甲状腺癌转移灶疗效的因素。

Objective To evaluate the clinical efficacy and analyze the risk factors of 131I treatment for differentiated thyroid cancer（DTC） patients with metastasis. Methods A retrospective analysis was made for 204 patients with DTC who received 131I treatment, and the efficacy of 131I treatment was evaluated with 131I imaging examination and serum thyroglobulin（Tg） detection. The factors influencing the therapeutic effects were also analyzed by Logistic regression. Results In 204 patients, 22.5% of patients included were cured and 60.8% were improving or remaining stable. Single factor analysis showed that age,metastatic site, the average dose of iodine, thyroid stimulating hormone （TSH） and Tglevel before treatment were correlated with clinical effects （ P 〈 0. 05 ）. Logistic regression analysis showed that age （ OR = 7.01,95 % CI 5.57-9.46 ）, Tg level （ OR = 0. 38,95 % CI 0. 14-0.77 ） and TSH level （ OR = 1.25, 95% CI 1.01-1.82）, the metastatic sites （ OR = 3. 12,95% CI 1. 14-5.67 ） affected 131I clean stoves effects. Conclusion 131I treatment for patients of DTC with metastasis is favorable. Age, Tg level, TSH level and distant metastasis are the factors influencing the effects.