放射性碘难治性分化型甲状腺癌的临床病理特征
Clinicopathological features of radioactive iodine-refractory differentiated thyroid cancer
姜贝贝 1李帅 2刘稳 3薛景丽 3李敏 2李培峰3
作者信息
- 1. 锦州医科大学解放军第九六○医院研究生培养基地,济南 250031;济南市第四人民医院病理科,济南 250031
- 2. 解放军第九六○医院核医学科,济南 250031
- 3. 锦州医科大学解放军第九六○医院研究生培养基地,济南 250031;解放军第九六○医院病理科,济南 250031
- 折叠
摘要
目的 探讨放射性碘难治性分化型甲状腺癌(RAIR-DTC)的临床病理特征,为甲状腺癌患者早期预测放射性碘难治(RAIR)提供临床依据.方法 回顾性分析2010年1月至2019年12月于解放军第九六○医院行甲状腺切除术并行1311治疗的84例患者的病例资料,将诊断为RAIR-DTC的39例患者作为研究组,将诊断为碘治疗有效性分化型甲状腺癌(RAIA-DTC)的45例患者作为对照组.比较两组临床病理特征,logis-tic 回归分析RAIR-DTC的独立危险因素,并确立RAIR-DTC预测模型.结果 与RAIA-DTC组 比较,RAIR-DTC组碘治疗次数更多,≥55岁、总碘治疗剂量、远处转移、TNM Ⅳ期患者比例、高危亚型和局灶钙化比例更高,肿瘤最大径更大,淋巴结转移数量更多,Ⅱ、Ⅰ+Ⅱ和非中央区淋巴结转移概率更高(P＜0.05).两组无进展生存率比较,差异有统计学意义(P＜0.05);两组总生存率比较,差异无统计学意义(P＞0.05).二元logistic回归分析结果显示,远处转移、高危亚型、肿瘤最大径≥10.5 mm是RAIR-DTC的独立危险因素(P＜0.05).获得拟合方程式logit(P)=-2.259+3.330X1+2.287X2+1.606X3,采用ROC曲线计算拟合方程式的截断值为-0.312 5,若logit(P)＞-0.312 5时,其可能发展为RAIR-DTC.结论 分化型甲状腺癌患者临床病理特征可有效预测RAIR.
Abstract
Objective To investigate the clinicopathological characteristics of radioactive Iodine-refrac-tory differentiated thyroid cancer(RAIR-DTC)to provide a clinical evidence for early prediction of the thyroid cancer patients with radioactive Iodine-refractory(RAIR).Methods The data of 84 patients with undergoing thyroidectomy and 131I therapy in PLA 960 hospital from January 2010 to December 2019 were retrospectively analyzed.Thirty-nine patients with diagnosed RAIR-DTC served as the study group and 45 cases of radioactive iodine-avid differentiated thyroid cancer(RAIA-DTC)served as the control group.The clinicopathological characteristics were compared between the two groups.The logistic regression was used to analyze the inde-pendent risk factors of RAIR-DTC,and the RAIR-DTC prediction model was established.Results Compared with the RAIA-DTC group,the RAIR-DTC group had more iodine treatment times,the proportions of the pa-tients with age ≥55 years old,total iodine therapeutic dose,distant metastasis,TNM stage Ⅳ,high-risk sub-types and focal calcification were higher,the tumor maximum diameter was greater,the number of lymph node metastases was more and the probability of Ⅱ,Ⅰ+Ⅱ and non-central lymph node metastases was higher(P＞0.05).The progression-free survival rate had statistical difference between the two groups(P＜0.05).The total survival rate had no statistical difference between the two groups(P＞0.05).The binary logistic re-gression analysis results showed that the distant metastasis,high-risk histological subtype and maximum tumor diameter ≥10.5 mm were the independent risk factors for RAIR-DTC.The obtained fitting equation logit(P)=-2.259+3.330X1+2.287X2+1.606X3,the ROC curve was used to calculate the truncation val-ue of the fitted equation as-0.312 5,when logit(P)＞-0.312 5,it might develop into RAIR-DTC.Conclusion The clinicopathological characteristics of the patients with differentiated thyroid cancer could ef-fectively predict RAIR.
关键词
分化型甲状腺癌/放射性碘难治/乳头状癌/滤泡性癌/远处转移Key words
differentiated thyroid carcinoma/Iodine-refractory/papillary thyroid carcinoma/follicular carcinoma/distant metastasis引用本文复制引用
基金项目
山东省自然科学基金面上项目(ZR2023MH029)
山东省医药卫生科技发展计划(202201041061)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据