分化型甲状腺癌：单中心 249 例患者治疗和随访分析。

Differentiated thyroid carcinoma: an analysis of 249 patients undergoing therapy and aftercare at a single institution.

机构信息

From the *Nuclear Medicine Department, Faculty of Medicine, Cairo University; and †Nuclear Medicine Department, Maadi Military Hospital, Cairo, Egypt.

出版信息

Clin Nucl Med. 2014 Feb;39(2):142-6. doi: 10.1097/RLU.0000000000000324.

DOI:10.1097/RLU.0000000000000324

PMID:24368533

Abstract

PURPOSE

Well-differentiated thyroid cancer (WDTC) is rising in incidence across the world over the past 3 decades. We aimed to evaluate the natural history and clinical outcome of differentiated thyroid carcinoma by a retrospective analysis of 249 patients treated at a single institution.

METHODS

A cohort of 249 patients who underwent thyroidectomy for WDTC in the last 10 years in Maadi Military Hospital was studied. Main outcome measures were clinical management at the diagnosis, survival, morbidity, and prognostic risk factors.

RESULTS

Mean age at diagnosis was 44.7 (SD, 14.6) years, where 52.2% were 45 years or older. Females represent 70.7% (P = 0.01), with female-to-male ratio of 4.1:1. Near-total thyroidectomy was done in 70.7% of the cases where papillary cancer was found in 80.8% and node metastasis in 10.5%. Radioactive I (RA I) was given an all cases (dose range, 80-150 mCi) with ablation success rate of 79.2%. Locoregional recurrence and metastasis (lungs and bones) were found in 2% and 6.8%, respectively. Multivariate Cox regression analysis showed that the mean ablation dose of RA I (odds ratio, 1.045; 95% confidence interval, 0.936-1.1189; P = 0.01) and presence of remote deposits (odds ratio, 1.049; 95% confidence interval, 0.836-1.1189; P = 0.01) are the significant influential factor in ablation success rate and survival, respectively.

CONCLUSIONS

Our data suggest that proper ablation dose of RA I and absence of remote metastasis are the powerful predictors for excellent outcome in WDTC patients.

摘要

目的

在过去的 30 年中，全世界分化型甲状腺癌（WDTC）的发病率呈上升趋势。我们旨在通过对单机构治疗的 249 例患者进行回顾性分析，评估分化型甲状腺癌的自然史和临床结局。

方法

研究了过去 10 年在 Maadi 军事医院因 WDTC 接受甲状腺切除术的 249 例患者的队列。主要观察指标为诊断时的临床处理、生存、发病率和预后危险因素。

结果

诊断时的平均年龄为 44.7（SD，14.6）岁，其中 52.2%为 45 岁或以上。女性占 70.7%（P=0.01），女性与男性的比例为 4.1:1。近全甲状腺切除术在 70.7%的病例中进行，其中 80.8%发现乳头状癌，10.5%发现淋巴结转移。所有病例均给予放射性碘（RA I）（剂量范围 80-150 mCi），消融成功率为 79.2%。局部区域复发和转移（肺部和骨骼）分别为 2%和 6.8%。多变量 Cox 回归分析显示，RA I 的平均消融剂量（比值比，1.045；95%置信区间，0.936-1.1189；P=0.01）和远处转移的存在（比值比，1.049；95%置信区间，0.836-1.1189；P=0.01）是消融成功率和生存的显著影响因素。