老年分化型甲状腺癌术后131I治疗及其临床价值  

Clinical value of radioiodine ablation of differentiated thyroid carcinoma in elder patients after thyroidectomy

作　　者：常伟[1] 高再荣[1] 崔坤炜[1] 张雅婧[1] 张永学[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院核医学科湖北省分子影像重点实验室,湖北武汉430022

出　　处：《中国医学影像技术》2010年第8期1549-1552,共4页Chinese Journal of Medical Imaging Technology

基　　金：卫生部部属(管)医院临床学科重点项目(卫规财函[2007]353号)

摘　　要：目的探讨131I治疗老年分化型甲状腺癌（DTC）的疗效和预后影响因素。方法 37例患者均已接受手术治疗,经术后病理学诊断确诊为甲状腺乳头状癌及其亚型,其中22例伴有淋巴结转移,9例合并有远处转移。术后和停服左旋甲状腺素片3~4周后行131I治疗,两次治疗间隔3~6个月。定期复查血清FT3、FT4、TSH、TgAb、Tg、血常规及肝肾功能等指标以及超声、CT及MR等相关影像学检查。结果 131I治疗后随访1~45个月,20例部分缓解,17例稳定,未出现复发及新的转移灶。结论老年DTC术后易复发及远处转移,预后较差,年龄、原发灶的外侵和远处转移是影响其预后的重要因素。术后行131I治疗可明显改善预后,提高患者的生存质量。Objective To retrospectively analyze the clinical features of elder patients with differentiated thyroid cancer（DTC）,and to evaluate the outcome and safety of radioiodine treatment.Methods Clinical data of 37 elder DTC patients were included in this study.All of them underwent thyroidectomy,22 had regional lymph nodes metastatic lesions,9 had distant metastasis.Postoperative pathological diagnosis was papillary thyroid carcinoma and its subtypes.All patients had 131I radioiodine therapy 3—4 weeks after thyroidectomy.Serum FT3,FT4,TSH,TgAb,Tg and other detail examinations（including blood routine examination,hepatic and renal function,US,CT and MRI,etc.） were essential in every return visit.Results The follow-up period was from 1 to 45 months after radioiodine 131I therapy.Twenty patients were release,17 were stable,no new recurrence and distant metastases.Conclusion The prognosis of elder patients with DTC gets worse with advancing age,extrathyroidal extension and distant metastasis.Postoperative 131I therapy should be the standard treatment approach for elder patients to improve prognosis and the quality of life.

关 键 词：甲状腺肿瘤 老年 治疗 预后 

分 类 号：R736.1[医药卫生—肿瘤] R817.8[医药卫生—临床医学]