分化型甲状腺癌伴肺转移65例患者的临床病理特征及预后分析
The clinicopathologic characteristics and prognosis of 65 differentiated thyroid cancer patients with lung metastasis
贾永胜 1李大鹏 1张艳 1张利卜 2杨晓勇 1胡琳斐 1戴东 2郑向前1
作者信息
- 1. 天津医科大学肿瘤医院甲状腺颈部肿瘤科 国家恶性肿瘤临床医学研究中心 天津市恶性肿瘤临床医学研究中心 天津市肿瘤防治重点实验室,天津 300060
- 2. 天津医科大学肿瘤医院分子影像及核医学诊疗科国家恶性肿瘤临床医学研究中心 天津市恶性肿瘤临床医学研究中心 天津市肿瘤防治重点实验室,天津 300060
- 折叠
摘要
目的 探讨接受131I治疗的分化型甲状腺癌(DTC)伴肺转移患者的临床病理特征及预后危险因素.方法 收集2010年1月1日至2016年12月31日在天津医科大学肿瘤医院接受131I治疗的65例DTC伴肺转移患者,分析其临床病理特点及影响预后的危险因素.结果 本组65例DTC患者中男18例,女47例;年龄14～73岁,中位年龄51岁;甲状腺乳头状癌56例,甲状腺滤泡癌9例;中位随访时间99.4个月,死亡23例,生存42例.DTC伴肺转移高发年龄男性为50～59岁,女性为40～49岁.以AJCC第八版TNM分期分组,Ⅱ期(年龄＜55岁)患者37例,Ⅳb期(年龄≥55岁)患者28例.进行131I治疗1～13次,平均3.9次.单纯肺转移患者55例,肺转移同时伴有其他器官远处转移患者10例.131I治疗后存在永久性甲状旁腺功能减低患者11例.COX多因素回归分析发现年龄是影响预后的独立危险因素,病理类型和多器官远处转移是影响预后的相对危险因素.结论DTC发生单纯肺转移后可以有较长的生存期,但合并多器官转移时预后较差.年龄、多发器官远处转移是影响预后的独立危险因素.
Abstract
Objectives To explore the clinicopathological characteristics and prognostic risk factors in differentiated thyroid cancer(DTC)patients with lung metastasis.Methods Patients of differentiated thyroid cancer with lung metastasis in Tianjin Medical University Cancer Institute &Hospital were enrolled from Jan 1,2010 to Dec 31,2016.The clinicopathological characteristics and risk factors affecting the prognosis were analyzed retrospectively.Results A total of 65 DTC patients with lung metastasis were collected in this study,including 56 patients with papillary thyroid carcinoma and 9 patients with follicular thyroid carcinoma;23 patients died and 42 patients survived.Median follow-up time was 99.4 months.There were 18 males,47 females.Age 14-73 years,median age 51.0 years.High incidence of DTC lung metastasis was 50-59 years for males and 40-49 years for females.Based on AJCC 8th edition TNM staging,there were 37 patients in stage Ⅱ(age＜55 years)and 28 patients in stage Ⅳ b(age ≥55 years).The number of131I treatments performed ranged from 1 to 13 times,with a mean of 3.9 times.Firty-five patients were with lung metastasis alone,and 10 patients with lung metastasis and distant metastasis in other organs.Eleven patients suffered from hypoparathyroidism after 1311 treatment.COX multifactorial regression analysis found that age was independent risk factor affecting prognosis,multiple organs distant metastasis and pathologic subtype were relative risk factors affecting prognosis.There was no correlation between gender,number of 131I treatments and poor prognosis.Conclusions DTC has a high survival even with the occurrence of lung metastasis,but the prognosis is poor when combined with multi-organ metastasis.Age and multiple organ distant metastatic are independent risk factors affecting prognosis.
关键词
甲状腺肿瘤/肿瘤转移/病理学,临床/预后Key words
Thyroid neoplasms/Neoplasm metastasis/Pathology,clinical/Prognosis引用本文复制引用
基金项目
国家自然科学基金(82272721)
国家自然科学基金(82303871)
天津市医学重点学科(专科)建设项目(TJYXZDXK-012A)
天津市医学重点学科(专科)建设项目(TJYXZDXK-009A)
出版年
2024
NETL
NSTL
万方数据