甲状腺乳头状癌术后有无残余甲状腺组织对^(131)I清甲疗效的影响  

The Influence of the Presence of Residual Thyroid Tissues on Iodine 131 Thyroid Ablation after Surgery for Papillary Thyroid Carcinoma

作　　者：石飞[1] 贾冰[1] 高芸[1] 

机构地区：[1]江苏省原子医学研究所,江苏无锡214063

出　　处：《中外医学研究》2014年第35期67-69,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:对手术残余较多甲状腺组织的甲状腺乳头状癌术后患者以及手术残余较少的甲状腺乳头状癌术后患者131I治疗效果进行对比评估。方法:对笔者所在医院56例无明显远行转移及局部侵犯的甲状腺乳头状癌术后患者在术后1~2个月给予口服131I治疗1次,治疗前查甲状腺彩超评估甲状腺残余组织有无,若有残余则估算残余组织大小,治疗3 d后给予甲状腺激素抑制治疗,治疗后1周查ECT全身131I显像,治疗后4~6个月后再次检查ECT全身131I显像及超声评估甲状腺残余组织有无及查血HTG值评估治疗效果。结果:经过131I清甲治疗后,无残余甲状腺组清甲成功率为95.4545%(42/44),有残余甲状腺组清甲成功率为58.3333%(7/12),比较差异有统计学意义(字2=11.819,P=0.00)。结论:清甲是否彻底和残余甲状腺大小有相关性,清甲不彻底者需要作第二次131I以达清甲目的。Objective：To compare and evaluate the iodine 131 therapeutic effects on patients with abundant or poor residual thyroid tissues after surgery for papillary thyroid carcinomas.Method：56 patients in our hospital without apparent metastases and local invasion were treated with iodine 131 solutions by oral administration during 1-2 months after surgery for papillary thyroid carcinoma.Thyroid ultrasound was used to estimate the presences and the volumes of residual thyroid tissues before treatment.Thyroid hormone suppressive therapy were performed at 3 days after treatment.Iodine-131 whole body ECT imaging was first applied at 1 week after treatment and again used at 4-6 months after treatment.During the same time,ultrasound was used to estimate the presences of residual thyroid tissues and therapy effects were evaluated by the values of HTG.Result：After the treatment of iodine 131,the success rate of thyroid removal were 58.3333%（7/12） and 95.4545%（42/44） respectively in had or not had residual thyroid group,the difference was statistically significant（ χ^2=11.819,P=0.00）.Conclusion：There is a correlation between remove the thyroid whether completely and residual thyroid size.Patients with incomplete clearance need to receive the second iodine 131 therapy for thyroid ablation.

关 键 词：甲状腺乳头状癌 治疗 同位素^131I 

分 类 号：R736.1[医药卫生—肿瘤]