分化型甲状腺癌骨转移的相关危险因素分析

发布时间：2018-11-09 19:24

【摘要】：目的:分析分化型甲状腺癌(Differentiated Thyroid Carcinoma,DTC)骨转移的相关危险因素。研究方法:回顾2012年6月至2017年3月在广西医科大学第一附属医院核医学科就诊的960例DTC患者,纳入骨转移组31例,根据随机抽样方式纳入非骨转移组119例,本研究对象共150例。整理病例的性别、年龄、诊断骨转移时间、甲状腺资料(手术方式、癌灶、病理类型)、颈部淋巴结(清扫、转移)、骨转移灶穿刺或术后病理类型及术后首次清甲时间的资料。采用X~2检验、Logistics回归分别行单因素及多因素分析,探讨DTC骨转移的相关危险因素。结果:DTC骨转移发生率3.2%(31/960)。单因素分析:年龄(X~2=10.554,P=0.005)、诊断骨转移时间(X~2=7.274,P=0.026)、甲状腺癌灶单侧或双侧(X~2=15.444,P=0.000)、术后病理(X~2=7.688,P=0.006)、颈部淋巴结清扫(X~2=6.072,P=0.048)、术后首次清甲时间(X~2=29.408,P=0.000)与骨转移的发生有相关性;Logistics多因素回归分析:Logistics(P)=-6.487-4.067(年龄20-45岁)+4.236(甲状腺双侧癌灶)-5.126(颈部淋巴结未清扫)+3.877(首次清甲时间6-12月)+3.921(首次清甲时间12月)+3.858(首次清甲时间不详)。结论:年龄小、甲状腺双侧癌灶、颈部淋巴结未清扫及术后首次清甲时间≥6月是DTC骨转移的确切危险因素。
[Abstract]:Objective: to analyze the risk factors of bone metastasis in differentiated thyroid carcinoma (Differentiated Thyroid Carcinoma,DTC). Methods: from June 2012 to March 2017, 960 patients with DTC in Department of Nuclear Medicine, first affiliated Hospital of Guangxi Medical University, including 31 cases of bone metastasis group and 119 cases of non-bone metastasis group according to random sampling, were reviewed. A total of 150 cases were included in this study. Sex, age, time for diagnosis of bone metastasis, thyroid data (surgical mode, cancer focus, pathological type), cervical lymph nodes (dissection, metastasis), Pathological types of bone metastases and the time of first nail removal after operation. The risk factors related to bone metastasis of DTC were analyzed by single factor analysis and multivariate analysis by using X2 test and Logistics regression. Results: the incidence of bone metastasis in DTC was 3.2% (31 / 960). Univariate analysis: age (X2 / 10. 554), time for diagnosis of bone metastasis (X2 / 7. 274), unilateral or bilateral thyroid carcinoma (X = 215.444 / P = 0. 000), postoperative pathology (XD = 22. 688P0. 006). The neck lymph node dissection (X2 + 6.072) and the first nail clearance time (X2 + 29.408) were correlated with the occurrence of bone metastasis. Logistics multivariate regression analysis: Logistics (P) = -6.487-4.067 (age 20-45) 4.236 (bilateral thyroid carcinoma)-5.126 (neck lymph node undissected) 3.877 (first de-thyroid time: 6-12 months) 3.921 (first clear time December) 3.858 (first clear time unknown). Conclusion: the risk factors of DTC bone metastasis are small age, bilateral thyroid cancer focus, undissected cervical lymph nodes, and the first time of de-thyroidism after operation 鈮，

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