甲状腺摄碘率预测分化型甲状腺癌患者^131I治疗后体内残留活度的价值  

Value of thyroid radioactive iodine uptake on predicting the residual activity in patients with differentiated thyroid carcinoma after ^131I treatment

作　　者：陈畅 沈阳[1] 吴永霞 邹惠峰 倪文杰 孙彤 王倩[1] 杨仪 Chen Chang;Shen Yang;Wu Yongxia;Zou Huifeng;Ni Wenjie;Sun Tong;Wang Qian;Yang Yi(Department of Nuclear Medicine,the Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China)

机构地区：[1]南京医科大学附属苏州科技城医院核医学科,215153

出　　处：《中华核医学与分子影像杂志》2020年第10期595-598,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨甲状腺摄碘率预测分化型甲状腺癌(DTC)患者^131I治疗后体内残留活度的价值。方法研究对象为2018年8月至2019年4月间在苏州科技城医院接受术后首次^131I治疗的178例DTC患者[男63例,女115例,年龄(39.8±11.4)岁],治疗前所有患者均进行甲状腺摄碘率测定和甲状腺显像。根据甲状腺显像结果将患者分为无残余甲状腺(简称残甲)组、少量残甲组、明显残甲组,分别于患者服用治疗剂量^131I后即刻、24 h、48 h及72 h测量辐射剂量当量率,估算体内残留^131I活度。采用单因素方差分析比较不同残甲组间甲状腺摄碘率和治疗后72 h体内残留^131I活度的差异,以Pearson相关分析研究甲状腺摄碘率、^131I治疗剂量与治疗后72 h体内残留^131I活度的关系,并建立甲状腺摄碘率与治疗后72 h体内残留^131I活度的回归方程。结果无残甲组(45例)、少量残甲组(101例)和明显残甲组(32例)间3 h甲状腺摄碘率分别为(4.77±1.46)%、(5.53±1.70)%和(8.92±3.75)%,差异有统计学意义(F=39.35,P<0.01);3组间24 h甲状腺摄碘率差异也有统计学意义[(1.54±0.88)%、(3.41±2.55)%、(13.52±8.59)%;F=91.52,P<0.01];3组治疗后72 h体内残留^131I活度分别为(81.70±25.61)、(108.24±51.58)和(283.07±133.72)MBq(F=92.84,P<0.01)。甲状腺摄碘率与72 h体内残留^131I活度呈正相关(3 h:r=0.753,24 h:r=0.817,均P<0.01),甲状腺3 h、24 h摄碘率与72 h体内残留^131I活度之间的直线回归方程分别为y=28.88x-38.42和y=13.87x+67.01,当3 h甲状腺摄碘率大于24.01%或24 h大于15.18%时,治疗后72 h体内残留^131I活度很可能超过400 MBq。72 h体内残留^131I活度与^131I治疗剂量间没有相关性(r=0.119,P>0.05)。结论甲状腺摄碘率可以用来预测首次接受^131I治疗的DTC术后患者在治疗后72 h的体内残留^131I活度。Objective To explore the value of thyroid radioactive iodine uptake(RAIU)on predicting the residual activity in patients with differentiated thyroid carcinoma(DTC)after administration of ^131I.Methods A total of 178 patients(63 males,115 females,age:(39.8±11.4)years)with DTC who underwent initial treatment of ^131I in Suzhou Science&Technology Town Hospital between August 2018 and April 2019 were enrolled in this retrospective study.RAIU test and thyroid imaging were performed before ^131I treatment.Patients were divided into 3 groups according to the thyroid remnant showed by thyroid imaging:no remnant group,a little remnant group,and obvious remnant group.Radiation dose equivalent rates at different time points(immediately/24 h/48 h/72 h after injection of ^131I)were measured to estimate the residual activity of ^131I after administration.RAIU and residual activity at 72 h among different thyroid remnant groups were compared by one-way analysis of variance.Relationship between RAIU/^131I therapeutic dose and residual activity at 72 h was analyzed by Pearson correlation analysis.The linear regression equation between RAIU and residual activity at 72 h after treatment was established.Results The 3 h RAIU in no remnant group(n=45),a little remnant group(n=101),and obvious remnant group(n=32)were(4.77±1.46)%,(5.53±1.70)%and(8.92±3.75)%,respectively(F=39.35,P<0.01),and the 24 h RAIU was also significantly different among those 3 groups((1.54±0.88)%,(3.41±2.55)%,(13.52±8.59)%;F=91.52,P<0.01).The residual activity at 72 h in no remnant group,a little remnant group,and obvious remnant group were(81.70±25.61),(108.24±51.58)and(283.07±133.72)MBq,respectively(F=92.84,P<0.01).There was a significant positive correlation between RAIU and the residual activity at 72 h(3 h:r=0.753,24 h:r=0.817,both P<0.01).The linear regression equations between RAIU at 3 h and 24 h and the residual activity at 72 h were y=28.88x-38.42 and y=13.87x+67.01,respectively.When RAIU was higher than 24.01%at 3 h or 15.18%at 24 h,the residu

关 键 词：甲状腺肿瘤 放射疗法 碘放射性同位素 放射性核素显像 预测 

分 类 号：R736.1[医药卫生—肿瘤]