目的：探讨术前血清Cyfra 21-1水平与分化型甲状腺癌(differentiated thyroid cancer，DTC)临床病理特征的关系及对预后评估的意义。方法：收集2013年1月至2016年6月在第三军医大学附属西南医院治疗的124例DTC患者的临床资料，选取同时期152例甲状腺良性肿瘤及66名健康体检患者作为对照，比较3组患者术前血清Cyfra 21-1水平，并分析其与DTC患者临床病理特征及术后复发的关系。结果：DTC组及良性肿瘤组的血清Cyfra 21-1水平均显著高于正常对照组(均P<0.01)，但DTC组及良性肿瘤组间的血清Cyfra 21-1水平差异无统计学意义(均P>0.05)。术前血清Cyfra21-1水平与DTC病理类型、TNM分期、是否出现淋巴结转移及局部浸润相关(均P<0.05)，与年龄、性别及肿瘤大小无关(均P>0.05)。DTC患者的5年累计无瘤生存率为83.3%。单因素分析显示性别、病理类型、TNM分期、是否有淋巴结转移、局部浸润、术前血清Cyfra21-1水平与DTC术后复发相关(均P<0.05)；多因素分析显示TNM分期较晚及术前高水平的血清Cyfra21-1是DTC患者术后复发的独立危险因素(均P<0.05)。结论：术前血清Cyfra21-1水平对DTC的诊断帮助不大，但是有助于提示部分临床病理特征，而且术前血清Cyfra21-1升高是影响DTC患者术后复发的独立危险因素。
Relationship of preoperative serum Cyfra 21-1 with clinicopathology and prognosis of differentiated thyroid cancer
Objective: To investigate the relationship of preoperative serum Cyfra 21-1 with clinicopathology and prognosis of differentiated thyroid cancer (DTC) patients. Methods: Totally 124 patients with DTC, 152 patients with thyroid benign tumors, and 66 health examination professionals from January 2013 to June 2016 in Southwest Hospital Affiliated to Third Military Medical University were reviewed. The levels of serum Cyfra 21-1 between the three groups were compared. Clinicopathological variables associated with the preoperative level of serum Cyfra 21-1 and their prognostic value were analyzed. Results: The level of serum Cyfra 21-1 in the DTC and benign tumor groups were significantly higher than that in the normal control group (all P<0.01). But the differences of serum Cyfra 21-1 between the DTC and benign tumor group were not significant (all P>0.05). The level of preoperative serum Cyfra 21-1 was significantly correlated with pathological type, TNM stage, lymphatic metastasis and local invasion (all P<0.05), and not related to gender, age and tumor size (all P>0.05). The 5-year disease-free survival rate of DTC patients was 83.3%. Univariate analysis showed that postoperative recurrence was associated with gender, pathological type, TNM stage, lymphatic metastasis, local invasion and the level of preoperative serum Cyfra 21-1 (all P<0.05). Multivariate analysis showed that late TNM stage and high level of preoperative serum Cyfra 21-1 were independent risk factors for postoperative recurrence (All P<0.05). Conclusion: The level of preoperative serum Cyfra 21-1 could not help diagnosis DTC, but they can prompt some clinicopathologic features. Serum Cyfra 21-1 was a potential independent prognostic factor for postoperative recurrence of DTC patients.