40例分化型甲状腺癌术后骨转移时间的影响因素分析

Influencing factors of time from thyroidectomy to bone metastasis for differentiated thyroid carcinoma

目的探讨分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后骨转移时间的危险因素。方法对解放军总医院2008年1月-2016年6月收治的40例DTC骨转移患者临床资料进行回顾性分析,探讨DTC术后影响骨转移时间的因素,单因素分析采用寿命表法,Wilcoxon检验;多因素分析采用Cox回归模型。结果 40例患者发生骨转移的平均时间为6.6±1.1年(0.5~28年)。单因素分析发现肿瘤甲状腺外浸润(P=0.033)、多灶癌(P=0.012)患者DTC术后骨转移时间更短。进一步行多因素Cox回归分析显示,肿瘤甲状腺外浸润(HR=2.138,P=0.033)、多灶癌(HR=2.293,P=0.018)影响DTC术后骨转移时间。结论肿瘤甲状腺外浸润和多灶癌是DTC术后骨转移时间的独立影响因素。

Objective To investigate the factors which influence the time from thyroidectomy to bone metastasis for differentiated thyroid carcinoma （DTC）. Methods Forty patients treated in Chinese PLA General Hospital from January 2008 to June 2016 and diagnosed with bone metastases resulting from DTC were enrolled in our study. The factors which influenced the time from thyroidectomy to bone metastasis for DTC were analyzed by Wilcoxon test, life table analysis and Cox regression analysis. Results The time from thyroidectomy to bone metastasis for DTC was 6.6±1.1 （0.5-28） years. Univariable analysis revealed that patients with extrathyroid extension （P =0.033） and multifocal lesions （P =0.012） had shorter time to metastasis. Multivariable Cox analysis revealed that extrathyroid extension （HR=2.138, P =0.033） and multifocal lesions （HR=2.293, P=0.018） influenced the metastasis. Conclusion Extrathyroid extension and multifocal lesions are the independent factors that influence the time from thyroidectomy to bone metastasis for DTC.