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目的:探讨分化型甲状腺癌(DTC)转移灶摄碘能力与n 131I清除不能手术切除的DTC转移灶(简称清灶)疗效的关系。n 方法:回顾性分析于31家单位核医学科行n 131I清灶治疗的138例DTC患者(男42例，女96例；年龄8～74岁)的临床资料。以清灶治疗时n 131I显像病灶靶/非靶(T/NT)比值代表其摄碘能力，以n 131I治疗前后病灶在影像上的径线变化评价该次疗效，分为完全缓解(CR)、部分缓解(PR)、稳定(SD)和进展(PD)。对可能影响n 131I清灶疗效的因素采用单因素分析(Kruskal－Wallis秩和检验，n χ2检验和单因素方差分析)及二元logistic回归分析，建立病灶T/NT比值预测清灶无效的受试者工作特征(ROC)曲线。n 结果:共统计1 165次疗效评估。在653次平面显像评估中，CR、PR、SD和PD 4个疗效组间病灶T/NT比值差异无统计学意义(n χ2＝4.15，n P>0.05)；在512次断层显像评估中，有39次(7.6%)CR、337次(65.8%)PR、117次(22.9%)SD和19次(3.7%)PD，4组间病灶T/NT比值差异有统计学意义(n χ2＝30.46，n P<0.01)。此外，年龄、刺激性甲状腺球蛋白(sTg)水平及服n 131I剂量也是影响n 131I清灶疗效的因素(n F值或n χ2值为2.561、7.095、8.799，均n P0.05). The tomographic imaging results (n n=512) suggested CR, PR, SD and PD in 7.6%(39/512), 65.8%(337/512), 22.9%(117/512), and 3.7%(19/512) of individuals, respectively, and the T/NT ratio among the four groups was significantly different (n χ2=30.46, n P<0.01). The univariate analysis also showed that age, stimulated thyroglobulin(sTg),n 131I dose were the factors affecting therapeutic efficacy (n F or n χ2 values: 2.561, 7.095 and 8.799, all n P<0.05). Furthermore, binary logistic regression analysis revealed that older patients (odds ratio (n OR)=1.034, n P=0.022) or patients with lower lesional T/NT (n OR=1.086, n P=0.006) had a higher probability of ineffectiveness. The area under ROC curve for T/NT ratio to predict ineffectiveness was 0.726, and the cut-off value was 6.2, with a sensitivity of 78.7%(107/136) and a specificity of 73.1%(275/376).n Conclusions:131I therapy is an effective treatment for metastatic DTC. The age at the time of metastatic diagnosis and the lesional T/NT ratio are independent influential factors for ineffectiveness of n 131I therapy. When the leisonal T/NT ratio is lower than 6.2, the inefficiency of n 131I is higher.n