不同剂量碘-131对甲状腺癌术后患者抑癌基因表达、甲状腺激素及染色体畸变的影响  

Effects of different doses of iodine-131 on tumor suppressor gene expression,thyroid hormone and chromosomal aberrations in patients after thyroid cancer surgery

作　　者：杨志森 耿丽 田贵金[1] 郝娜娜 柳树凯 张秀梅 YANG Zhisen;GENG Li;TIAN Guijin;HAO Nana;LIU Shukai;ZHANG Xiumei(Department of General Surgery,the First Hospital of Handan City in Hebei Province,Handan,Hebei,056000;Department of Internal Medicine,General Hospital of Handan Mining Group of North China Medical and Health Group,Handan,Hebei,056000;First Department of Neurology,Handan City Central Hospital in Hebei Province,Handan,Hebei,056000;Department of General Surgery,Linzhang County Hospital of Handan City in Hebei Province,Handan,Hebei,056000;Department of Otorhinolaryngology,the First Hospital of Handan City in Hebei Province,Handan,Hebei,056000)

机构地区：[1]河北省邯郸市第一医院综合外科,河北邯郸056000 [2]华北医疗健康集团邯矿总院内科,河北邯郸056000 [3]河北省邯郸市中心医院神经内一科,河北邯郸056000 [4]河北省邯郸市临漳县医院普外科,河北邯郸056000 [5]河北省邯郸市第一医院耳鼻喉科,河北邯郸056000

出　　处：《实用临床医药杂志》2021年第17期88-91,96,共5页Journal of Clinical Medicine in Practice

基　　金：河北省邯郸市科学技术研究与发展计划项目(19422083010-4)。

摘　　要：目的探讨不同剂量碘-131(^(131)I)治疗对甲状腺癌(TC)术后患者抑癌基因表达、甲状腺激素及染色体畸变的影响。方法回顾性分析120例TC术后首次行^(131)I治疗患者的临床资料,根据^(131)I治疗剂量分为低剂量组48例、中剂量组40例、高剂量组32例。比较3组患者^(131)I治疗后抑癌基因表达、甲状腺激素及染色体畸变的差异。结果与低剂量组患者比较,中剂量组、高剂量组患者CCNG2、PTEN基因的mRNA、蛋白表达量均升高,差异有统计学意义(P<0.05)。治疗后,3组患者的促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平均较治疗前降低,且高剂量组最低,低剂量组最高,差异有统计学意义(P<0.05)。治疗后7 d,3组患者的染色体总畸变率、双着丝粒体及着丝粒环率均高于治疗前,差异有统计学意义(P<0.05)。结论高剂量^(131)I可促进TC术后患者抑癌基因表达,降低甲状腺激素水平,不会增高染色体畸变率,在患者耐受情况下可作为^(131)I治疗的理想剂量。Objective To explore the effects of different doses of iodine-131(^(131)I)on tumor suppressor gene expression,thyroid hormone and chromosomal aberrations in patients after thyroid cancer(TC)surgeries.Methods Clinical materials of 120 patients with the first time ^(131)I treatment after TC operation were analyzed retrospectively,and they were divided into low dose group(n=48),medium dose group(n=40)and high dose group(n=32)according to the dose of ^(131)I treatment.The differences of tumor suppressor gene expression,thyroid hormone and chromosomal aberrations after ^(131)I treatment were compared among the three groups.Results Compared with the low dose group,the mRNA and protein expressions of CCNG2 and PTEN genes in the medium dose group and high dose group were significantly higher(P<0.05).After treatment,the levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3))and free thyroxine(FT_(4))in the three groups were significantly lower than those before treatment,and the high-dose group was the lowest and the low-dose group was the highest(P<0.05).At 7 days after treatment,the total chromosome aberration rate as well as bicentromeric body and centromeric ring rate of the three groups were significantly higher than those before treatment(P<0.05).Conclusion High dose ^(131)I treatment for patients with TC after surgery can promote the expression of tumor suppressor genes and reduce the level of thyroid hormone without increasing the rate of chromosomal aberrations,which can be used as the ideal dose of ^(131)I treatment under the patient's tolerance.

关 键 词：碘-131 甲状腺癌 抑癌基因 甲状腺激素 染色体畸变 

分 类 号：R736.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]