分化型甲状腺癌76例^(131)Ⅰ治疗临床分析  

Clinical analysis of 76 cases of differentiated thyroid carcinoma by ^(131)Ⅰ therapy

作　　者：宋补昌[1] 李晓峰[1] 丰波[1] 张承刚[2] 

机构地区：[1]山西医科大学第三医院核医学科,太原030053 [2]山西医科大学第一临床医学院核医学科

出　　处：《山西医科大学学报》2013年第12期960-962,共3页Journal of Shanxi Medical University

摘　　要：目的观察口服131I治疗分化型甲状腺癌患者效果,旨在探讨131I碘在甲状腺癌治疗中的作用和可行性。方法回顾分析我科2001-05~2012-04收治的甲状腺癌全切或次全切术后76例,给予口服131I治疗,服131I后6个月随访复查,通过监测131I全身显像、甲状腺球蛋白(Tg)、甲状腺球蛋白抗体(TgAb)、游离三碘甲状腺激素(FT3)、游离甲状腺激素(FT4)、促甲状腺激素(TSH)、颈部超声检查决定患者服131I情况。结果 76例甲状腺癌患者,有32例未发生转移的甲状腺癌,均经口服1次131I治愈,一次治愈率42.1%;有35例患者(5例无转移,30例有转移病灶)经过多次131I碘治疗后治愈,总治愈率达88.2%(67/76)。5例合并转移的DTC经过服131I治疗后甲状腺残留或转移病灶有所缩小但未消失,也没有发现新的转移灶及原有病灶扩散。总有效率94.7%。4例合并转移的DTC患者经多次131I疗效果不明显。多次大量服131I的患者也未出现严重不良反应。结论分化型甲状腺癌(DTC)术后应该服131I治疗,以预防和减少复发;残留较多甲状腺组织或有转移的需多次131I治疗;甲状腺癌术后131I治疗是安全、有效的。Objective To explore the value and the feasibility of ^131I therapy for differentiated thyroid carcinoma（DTC）. Methods Seventy-six patients with DTC undergoing near-total thyroidectomy and neck metastatic lymph nodes were enrolled from May 2001 to April 2012 and treated by ^131I. Patients were followed up 6 months after ^131I therapy. The dose of ^131I was given according to the results of radioiodine whole body scan and neck ultrasound, and the levels of Tg, TgAb, FT3, FT4, TSH. Results Of 76 DTC patients, 32 pa-tients were negative for the metastasis after ^131I therapy at 6 month, and the once cure rate was 42.1% （32/76） ;35 patients were cured by repeated ^131I therapy. The total cure rate of thyroid carcinoma was 88.2% （67/76）. Other five patients with DTC were effective, and the total effective rate was 94.7% （72/76）. Four patients were unsatisfactory. No serious adverse effects were found after repeated ^131I therapy. Conclusion DTC patients should be treated by ^131I to reduce the recurrence after operation. Patients with more thyroid remant or metastases of DTC should be given repeated ^131I therapy. ^131I therapy for thyroid carcinoma after operation is effective and safe.

关 键 词：分化型甲状腺癌 ^131碘 乳头状癌(PTC) 滤泡状癌(FTC) 

分 类 号：R817.8[医药卫生—影像医学与核医学]