关键词: 分化甲状腺癌, 骨转移, 危险因素, 预后

Abstract: Study on risk factors and prognostic indicators of bone metastasis in thyroid cancer        FENG Gui-cheng, LI Hong-qiang, LIU Zhen, et al. Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Engineering Research Center of Multidisciplinary Diagnosis and Treatment of Thyroid Cancer of Henan Province, Key Medicine Laboratory of Thyroid Cancer of Henan Province, Zhengzhou  450000, China
Corresponding author： YIN De-tao,E-mail:detaoyin@zzu.edu.cn
Abstract    Objective    To investigate the risk factors and prognostic indicators of bone metastasis in differentiated thyroid cancer (DTC). Methods    A retrospective analysis was conducted on 43 DTC patients with bone metastasis admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to September 2023 as the metastasis group. Data from 1457 DTC patients without bone metastasis treated during the same period were randomly selected as the non-bone metastasis group. Nine factors including general information, postoperative pathological types, and maximum tumor diameter were collected and analyzed. SPSS 27.0 software was used for statistical analysis, and χ2 test and Logistics regression analysis were applied to investigate the correlation between various risk factors and bone metastasis. In addition, a retrospective analysis was performed on 82 DTC patients with postoperative bone metastasis admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to September 2023. General information, pathological type, first symptoms, treatment methods, and other factors were collected. The Log-rank test was applied to analyze whether there were statistically significant differences between groups. Multivariate COX proportional hazards regression analysis was used to identify factors influencing disease progression. Results    In the bone metastasis group, patients aged ≥55 years, with pathological type of follicular carcinoma, cervical lymph node metastasis, combined with other distant metastases, and the presence of extrathyroidal extension of tumor were significantly higher than those in the non-bone metastasis group (P< 0.05). The lack of cervical lymph node dissection (P=0.07) was marginally correlated and was a risk factor for bone metastasis in DTC patients. In the predictive analysis, COX proportional hazards regression analysis revealed that pathological type, presence of other distant metastases, first symptoms, iodine uptake by metastatic lesions, and different treatment methods were statistically significant (P< 0.05). Conclusion    Age, follicular carcinoma, lack of cervical lymph node dissection, cervical lymph node metastasis, combined with other distant metastases, and the presence of extrathyroidal extension of tumor are risk factors for bone metastasis in DTC patients. Pathological type, presence of other distant metastases, first symptoms, iodine uptake by metastatic lesions, and different treatment modalities are important factors affecting the prognosis of DTC patients.

Key words: differentiated thyroid cancer, bone metastasis, risk factors, prognosis