【摘要】 目的筛选影响分化型甲状腺癌（DTC）远处转移131I治疗后疾病进展的因素。资料与方法回顾性分析115例接受¹³¹I治疗后DTC远处转移患者的临床资料。随访本组患者疾病无进展生存期,以转移灶最小时为观察起点,转移灶进展为观察终点,对比患者年龄、病理学类型、是否合并淋巴结转移、转移灶部位、转移灶大小、转移灶是否摄取¹³¹I等影响因素。应用Kaplan-Meier勾画疾病无进展生存曲线,分别进行log-rank检验和Cox比例风险回归分析。结果本组患者平均随访时间（4.5±3.8）年,中位随访时间3.5年。随访期间疾病进展37例（32.17%）。多变量Cox比例风险回归分析结果显示,患者转移灶部位（RR=0.280,95%CI 0.119～0.659,P=0.004）及¹³¹I摄取情况（RR=2.189,95%CI 1.048～4.571,P=0.037）与DTC患者远处转移的疾病进展有关。结论大部分DTC远处转移患者可通过规范治疗达到疾病无进展生存。转移灶部位及转移灶是否摄取¹³¹I是影响DTC伴远处转移患者疾病进展独立影响因素。更多还原

【Abstract】 Purpose To analyze the progression-free survival after the ¹³¹ I treatment of distant metastasis of differentiated thyroid cancer（DTC）, and to screen the factors influencing the disease progression. Materials and Methods A retrospective analysis was performed on the clinical data of 115 patients with DTC after ¹³¹ I treatment of distant metastasis, and the patients in this group were followed up for the disease progression-free survival. Then the minimum metastasis was taken as the starting point of observation and the metastasis progression was taken as the end point of observation to compare the patient age, pathological type, whether accompanied by lymph node metastasis, metastasis site, metastasis size, whether metastasis uptake of ¹³¹ I and other influencing factors. Next, the disease progression-free survival curves were plotted by Kaplan-Meier to perform the log-rank test and Cox proportional risk regression analysis,respectively. Results The average follow-up time was（4.5±3.8） years（median 3.5 years） of the patients in this group, and during the follow-up, 37 patients（32.17%） had disease progression. The multivariate Cox proportional risk regression analysis showed that metastasis site（RR=0.280, 95% CI 0.119-0.659, P=0.004） and ¹³¹ I uptake（RR=2.189, 95% CI 1.048-4.571, P=0.037） were related to the disease progression of distant metastasis in DTC patients. Conclusion Most patients with DTC distant metastasis could achieve progression-free survival through standard treatment. The metastasis site and whether the metastasis uptake of ¹³¹ I are independent factors influencing the disease progression of patients with DTC distant metastasis.更多还原