From the *Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran; †Department of Nuclear Medicine, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran; ‡The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr; and §Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran.
Clin Nucl Med. 2016 Dec;41(12):917-921. doi: 10.1097/RLU.0000000000001426.
Because one of the major sites for metastasis of thyroid cancers is the lung, studying the pattern of pulmonary metastasis may provide useful information for the effective treatment of these patients. In this study, by assessing the metastasis pattern, we aimed to identify the factors that may affect prognosis and response to treatment in patients with differentiated thyroid carcinoma (DTC) with pulmonary metastasis.
This retrospective study included 75 patients with DTC with pulmonary metastasis who were referred to our nuclear medicine section over a period of 10 years. The data obtained were analyzed with regard to response to treatment to assess the effects of the included factors on prognosis.
Of the 1746 patients referred to our section, 75 (4.3%) had pulmonary metastasis. According to the pattern of pulmonary metastasis, they were divided into 4 groups: nodular, diffuse, combined, and other. The mean age of the patients was 43.8 ± 18.5 years. After the follow-up, 58 patients survived, 14 of whom responded to the treatment. The mean number of radioiodine therapy sessions that the patients received was 3.2 ± 2, and the mean cumulative dose was 554.7 ± 387.8 mCi. Statistical analysis of the data revealed that there was no significant difference in the response to treatment between patients with different patterns of pulmonary metastasis (P > 0.3). However, significant differences were reported in the response to treatment between patients with papillary thyroid carcinoma and those with follicular thyroid carcinoma (P < 0.03). The 1-, 5-, and 9-year survival rates were reported as 98%, 76%, and 51%, respectively.
Patients with DTC with pulmonary metastasis have a relatively favorable prognosis and response rate, as well as longer survival. The type of DTC is the only factor that affects the response to treatment.
由于甲状腺癌的主要转移部位之一是肺部，因此研究肺部转移的模式可能为这些患者的有效治疗提供有用的信息。在这项研究中，通过评估转移模式，我们旨在确定可能影响分化型甲状腺癌（DTC）伴肺转移患者预后和治疗反应的因素。
本回顾性研究纳入了 10 年来我院核医学科就诊的 75 例 DTC 伴肺转移患者。对获得的数据进行分析，以评估治疗反应，评估纳入因素对预后的影响。
在我们科就诊的 1746 例患者中，75 例（4.3%）有肺转移。根据肺部转移模式，他们被分为 4 组：结节型、弥漫型、混合型和其他型。患者的平均年龄为 43.8±18.5 岁。随访后，58 例患者存活，其中 14 例对治疗有反应。患者接受放射性碘治疗的平均次数为 3.2±2 次，平均累积剂量为 554.7±387.8mCi。数据分析显示，不同肺转移模式患者的治疗反应无显著差异（P＞0.3）。然而，甲状腺乳头状癌和滤泡状甲状腺癌患者的治疗反应有显著差异（P＜0.03）。1、5、9 年生存率分别为 98%、76%和 51%。
DTC 伴肺转移患者的预后和治疗反应相对较好，生存时间较长。DTC 类型是唯一影响治疗反应的因素。
