影响分化型甲状腺癌肺转移患者预后的临床因素

Clinical factors that influencing the prognosis of differentiated thyroid carcinoma patients with lung metastasis

目的:探讨影响分化型甲状腺癌(DTC)肺转移患者预后的临床因素。方法:回顾性分析西安交通大学第一附属医院2011年至2017年间接受放射性碘治疗的DTC肺转移患者。根据随访患者影像学检查结果、无进展生存率(PFS)和癌症特异性生存率评估其肺转移病灶碘摄取能力和血清甲状腺球蛋白(Tg)水平对预后的影响。结果:最终63例患者被纳入分析。在中位随访35个月(5~91个月)后,多变量分析结果提示肺转移灶摄碘阴性,但Tg分泌阳性是DTC肺转移的独立预后因素,其是导致较短PFS的独立危险因素(P=0.032)。结论:肺转移灶摄碘阴性,但Tg分泌阳性是预测DTC肺转移不良结局最重要的预后因素。

Objective:To investigate the prognostic factors of the lung metastatic(LM)lesions in differentiated thyroid cancer(DTC).Methods:This retrospective study included 63 consecutive patients with LM from DTC treated with radioiodine between 2011 and 2017.Poor prognosis was defined as progressive disease or death,and factors predictive of the outcome were determined by multivariate analyses.Results:After a median follow-up period of 35 months(range,5~91 months),the radioiodine non-avid but Tg secretion positive LM was found to be an independent prognostic factor associated with shorter progression-free survival,even after adjustments for age,cervical lymph node metastasis,LM size,and cumulative radioiodine ablation activity(P=0.032).Conclusion:Radioiodine non-avid but Tg secretion positive LM is associated with a poor prognosis in DTC patients with LM.