Correlation between minimal extrathyroid invasion and recurrence in differentiated thyroid cancer

胡厚洋; 梁　军; 张　腾

doi:10.19401/j.cnki.1007-3639.2017.12.005

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Correlation between minimal extrathyroid invasion and recurrence in differentiated thyroid cancer

更新时间：2025-12-31

- Correlation between minimal extrathyroid invasion and recurrence in differentiated thyroid cancer
- China Oncology Vol. 27, Issue 12, Pages: 946-952(2017)
- 作者机构：
  
  1. 青岛大学附属医院肿瘤科,山东,青岛,266003
  2. 中国医学科学院北京协和医院核医学科,北京,100730
  3. 北京大学国际医院肿瘤科,北京,100142
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2017.12.005
  CLC：
- Published Online：11 January 2018，
  
  Published：11 January 2017
- 稿件说明：
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胡厚洋,梁　军,张　腾,等. 分化型甲状腺癌被膜及被膜外微小侵犯与复发风险[J]. 中国癌症杂志, 2017, 27(12): 946-952.

胡厚洋, 梁　军, 张　腾. Correlation between minimal extrathyroid invasion and recurrence in differentiated thyroid cancer[J]. China Oncology, 2017, 27(12): 946-952.
胡厚洋,梁　军,张　腾,等. 分化型甲状腺癌被膜及被膜外微小侵犯与复发风险[J]. 中国癌症杂志, 2017, 27(12): 946-952. DOI： 10.19401/j.cnki.1007-3639.2017.12.005.

胡厚洋, 梁　军, 张　腾. Correlation between minimal extrathyroid invasion and recurrence in differentiated thyroid cancer[J]. China Oncology, 2017, 27(12): 946-952. DOI： 10.19401/j.cnki.1007-3639.2017.12.005.

摘要

背景与目的：第八版TNM分期取消了分化型甲状腺癌(differentiated thyroid cancer，DTC)甲状腺外微小侵犯(minimal extra-thyroid invasion，MEI)对死亡风险的影响。该研究旨在采用美国甲状腺协会疗效反应评估系统探讨MEI与DTC颈部疾病复发/持续存在之间的关系。方法：回顾性研究942例就诊于北京协和医院的非远处转移型DTC患者，中位随访24个月，根据

131

I治疗后的疗效反应将患者分为结构性改变组(structural incomplete response，SIR，n=55)，即疾病复发/持续存在，与非SIR组(NSIR，n=887)；采用卡方检验、秩和检验等对比两组患者的临床病理特征，多因素分析法分析影响颈部复发的主要因素，同时对MEI与颈部复发进行相关性分析。对比低危组(n=39)与微小侵犯组(无其他危险因素，n=65)患者一般临床病理特点及131I治疗疗效反应的差异。结果：SIR组与非SIR组患者在肿瘤大小(P=0.018)、淋巴结分期(P=0.008)、甲状腺外明显侵犯(P=0.008)方面存在差异，在MEI方面差异无统计学意义(P=0.444)。多因素分析显示影响，患者复发的主要因素为肿瘤大小(P=0.007)与甲外明显侵犯(P=0.036)；相关性分析提示MEI与DTC颈部复发无明显相关(r = -0.026，P=0.425)。微小侵犯组在女性患者比率(P=0.018)、确诊年龄(P=0.033)方面略高于低危组，在肿瘤大小(P=0.517)、多灶性(P=1.000)、

131

I剂量(P=1.000)方面差异无统计学意义；经外科手术及

131

I治疗后两组患者复发率差异无统计学意义(1.5% vs 2.6%，P=0.244)。结论：MEI不是影响非远处转移性DTC颈部复发的危险因素。

Abstract

Background and purpose: The effect of minimal extrathyroid invasion (MEI) on mortality in differentiated thyroid cancer (DTC) patients was eliminated from the 8

TNM staging system. This study aimed to analyze the correlation between MEI and recurrence risk in DTC patients. Methods: We retrospectively analyzed 942 DTC patients without distant metastasis who were treated in Peking U

nion Medical College Hospital with a median follow-up of 24 months. Patients were divided into two groups: disease recurrence/persistence patients as structural incomplete response group (SIR

n=55)

and non-SIR as NSIR group (n=887) according to their response to therapy. Chi-square test and rank-sum test were used to evaluate the statistical differences in basic clinicopathologic features between two groups. Multivariate analysis was used to quantify the influence factors for SIR. Correlation analysis was conducted between MEI and recurrence. We compared the clinical-pathologic features and responses between low-risk group (G1

n=39) and minimal extrathyroid invasion group (G2

no other risk factors

n=65). Result: There were statistical differences in tumor size (P=0.018)

lymph node stage (P=0.008) and macroscopic extrathyroid invasion (P=0.008) between SIR group and NSIR group

and no significant difference in MEI (P=0.444) between the groups. Tumor size (P=0.007) and macroscopic extrathyroid invasion (P=0.036) were two independent influence factors for SIR in multivariate analysis. It showed no correlation between MEI and SIR (r=-0.026

P=0.425). G2 showed a high rate of female (P=0.018) and age at diagnosis (P=0.033) compared with G1. There was no significant difference in tumor size (P=0.517)

tumor multifocality (P=1.000) and dose of

131

I (P=1.000 )

as well as the recurrence between G1 and G2 (1.5% vs 2.6%

P=0.244). Conclusion: MEI should not be an independent risk factor for recurrence in DTC patients.

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中国医学科学院北京协和医学院北京协和医院核医学科

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