颈淋巴结清除术前不同剂量131I对甲状腺癌患者唾液腺功能和生活质量的影响及作用机制研究  

Effects of different doses of 131I on salivary gland function and quality of life in patients with thyroid cancer before cervical lymphadenectomy and its mechanism

作　　者：樊雪缘 杨绮 周凡[1] 廖杰[1] FAN Xueyuan;YANG Qi;ZHOU Fan;LIAO Jie(Department of Nuclear Medicine,Second People’s Hospital of Yibin,Yibin 644000,Sichuan,China)

机构地区：[1]宜宾市第二人民医院核医学科

出　　处：《癌症进展》2019年第18期2147-2150,共4页Oncology Progress

摘　　要：目的颈淋巴结清除术前不同剂量131I对甲状腺癌患者唾液腺功能和生活质量的影响及作用机制研究。方法采用随机数字表法将64例TC患者分为低剂量组和高剂量组,各32例。所有患者在颈淋巴结清除术前,均给予不同剂量的131I治疗。比较两组患者的唾液腺功能、生活质量;从两组患者的TC组织中提取细胞并分为低剂量亚组和高剂量亚组,比较两亚组的细胞周期和细胞凋亡率。结果治疗后,两组患者的唾液pH值较治疗前升高,静态唾液流率和动态唾液流率均较治疗前下降,差异均有统计学意义(P﹤0.05)。治疗后,低剂量组患者的唾液pH值低于高剂量组,静态唾液流率和动态唾液流率均高于高剂量组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的健康调查简表(SF-36)各维度评分均高于本组治疗前,差异均有统计学意义(P﹤0.05);低剂量组患者SF-36量表各维度评分均高于高剂量组,差异均有统计学意义(P﹤0.05)。低剂量亚组的G0/G1期细胞数和细胞凋亡率均明显低于高剂量亚组;S期和G2/M期细胞数均明显高于高剂量亚组,差异均有统计学意义(P﹤0.01)。结论术前1.1~3.7GBq治疗剂量的131I可减轻TC患者唾液腺功能损害,提高生活质量,值得临床借鉴。Objective To explore effects of different doses of 131I on salivary gland function and quality of life in patients with thyroid cancer(TC)before cervical lymphadenectomy and its mechanism.Method 64 patients with TC were divided into the low-dose group(32 cases)and the high-dose group(32 cases)by random number table method.All patients were treated with different doses of 131I before cervical lymph node dissection.The salivary gland function and quality of life in the two groups were compared.Cells extracted from TC tissues of the two groups were divided into low-dose subgroup and high-dose subgroup.Cell cycle and apoptosis rate were compared between the two subgroups.Result After treatment,the saliva pH values in the two groups were higher than before treatment,the static saliva flow rate and dynamic saliva flow rate were lower than before treatment(P<0.05).After treatment,the saliva pH values in the low-dose group were lower than those in the high-dose group,saliva flow rate and saliva flow rate were higher than those in the high-dose group(P<0.05).After treatment,the scores of each dimension of SF-36 scale in the two groups were higher than those before treatment,and the difference was statistically significant(P<0.05).After treatment,the scores of SF-36 scale in the low-dose group were higher than those in the high-dose group(P<0.05).After treatment,the apoptosis rate and G0/G1 phase cells in the low-dose subgroup were lower than those in the high-dose subgroup,and the S phase cells and G2/M ratio were significantly higher than those in the high-dose subgroup(P<0.01).Conclusion The 131I dose of 1.1-3.7 GBq before operation can alleviate salivary gland dysfunction and improve the quality of life in TC patients.It is worthy of clinical application.

关 键 词：131I 颈淋巴结清除术 甲状腺癌 唾液腺功能 生活质量 

分 类 号：R736.1[医药卫生—肿瘤]