【摘要】：目的:分析分化型甲狀腺癌(Differentiated Thyroid Carcinoma,DTC)骨轉(zhuǎn)移的相關(guān)危險(xiǎn)因素。研究方法:回顧2012年6月至2017年3月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院核醫(yī)學(xué)科就診的960例DTC患者,納入骨轉(zhuǎn)移組31例,根據(jù)隨機(jī)抽樣方式納入非骨轉(zhuǎn)移組119例,本研究對(duì)象共150例。整理病例的性別、年齡、診斷骨轉(zhuǎn)移時(shí)間、甲狀腺資料(手術(shù)方式、癌灶、病理類型)、頸部淋巴結(jié)(清掃、轉(zhuǎn)移)、骨轉(zhuǎn)移灶穿刺或術(shù)后病理類型及術(shù)后首次清甲時(shí)間的資料。采用X~2檢驗(yàn)、Logistics回歸分別行單因素及多因素分析,探討DTC骨轉(zhuǎn)移的相關(guān)危險(xiǎn)因素。結(jié)果:DTC骨轉(zhuǎn)移發(fā)生率3.2%(31/960)。單因素分析:年齡(X~2=10.554,P=0.005)、診斷骨轉(zhuǎn)移時(shí)間(X~2=7.274,P=0.026)、甲狀腺癌灶單側(cè)或雙側(cè)(X~2=15.444,P=0.000)、術(shù)后病理(X~2=7.688,P=0.006)、頸部淋巴結(jié)清掃(X~2=6.072,P=0.048)、術(shù)后首次清甲時(shí)間(X~2=29.408,P=0.000)與骨轉(zhuǎn)移的發(fā)生有相關(guān)性;Logistics多因素回歸分析:Logistics(P)=-6.487-4.067(年齡20-45歲)+4.236(甲狀腺雙側(cè)癌灶)-5.126(頸部淋巴結(jié)未清掃)+3.877(首次清甲時(shí)間6-12月)+3.921(首次清甲時(shí)間12月)+3.858(首次清甲時(shí)間不詳)。結(jié)論:年齡小、甲狀腺雙側(cè)癌灶、頸部淋巴結(jié)未清掃及術(shù)后首次清甲時(shí)間≥6月是DTC骨轉(zhuǎn)移的確切危險(xiǎn)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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