分化型甲状腺癌患者术后首次^(131)I清除残余甲状腺疗效的影响因素  

Factors influencing the efficacy of residual thyroid clearance with ^(131)I for the first time after surgery in patients with differentiated thyroid cancer

作　　者：游硕 王慧玲[1] 方萌 You Shuo;Wang Huiling;Fang Meng(Two Families of External Mammary Gland,Hunan Provincial People′s Hospital,Changsha 410016,China)

机构地区：[1]湖南省人民医院乳甲外二科,长沙410016

出　　处：《中国医师杂志》2023年第6期891-894,共4页Journal of Chinese Physician

摘　　要：目的探讨分化型甲状腺癌(DTC)患者术后首次^(131)I清除残余甲状腺疗效的影响因素。方法回顾性分析2018年1月至2021年2月湖南省人民医院收治的100例首次行^(131)I治疗的DTC患者临床资料,分别比较采用不同^(131)I剂量、不同病理类型、不同治疗时间首次清甲的成功率,logistics回归分析DTC患者术后首次^(131)I清除残余甲状腺疗效的影响因素。结果清甲成功患者为54例,清甲未成功患者为46例,清甲成功率为54%。^(131)I剂量为80 mCi、90 mCi、100 mCi的患者首次清甲成功率分别为37.50%(12/32)、52.78%(19/36)、71.88%(23/32),各组比较差异具有统计学意义(P<0.05);滤泡状癌患者、乳头滤泡混合型癌患者、乳头状癌患者首次清甲成功率分别为65.71%(23/35)、39.13%(9/23)、52.38%(22/42),各组比较差异无统计学意义(P>0.05);1组患者(治疗时间<3个月)、2组患者(治疗时间3~12个月)、3组患者(治疗时间>12个月)首次清甲成功率分别为68.09%(32/47)、44.44%(16/36)、6/17,各组比较差异无统计学意义(P>0.05);不同性别、年龄、病理分期、促甲状腺激素(TSH)水平的DTC患者清甲成功率比较,差异无统计学意义(均P>0.05);不同转移情况、刺激性甲状腺球蛋白(sTg)的DTC患者清甲成功率比较,差异具有统计学意义(均P<0.05);sTg、术后淋巴结转移与术后远处转移是DTC患者术后首次^(131)I清除残余甲状腺疗效的独立危险因素(均P<0.05)。结论首次^(131)I清除残余甲状腺疗效的影响因素包括^(131)I剂量的差异、治疗期间有无转移灶、Tg水平等,降低Tg水平是提高缓解率的重要因素,控制淋巴结及远处转移是首次^(131)I清除残余甲状腺疗效成功的关键要素。Objective To explore the influencing factors of residual thyroid clearance with ^(131)I after surgery in patients with differentiated thyroid cancer(DTC).Methods A retrospective analysis was conducted on the clinical data of 100 DTC patients admitted to the Hunan Provincial People′s Hospital from January 2018 to February 2021 who underwent ^(131)I treatment for the first time.The success rates of first thyroidectomy using different doses of ^(131)I,different pathological types,and different treatment times were compared,and logistic regression analysis was conducted to investigate the influencing factors of the efficacy of first postoperative ^(131)I thyroidectomy in DTC patients.Results A total of 54 patients successfully cleared residual thyroid,46 patients failed to clear residual thyroid,and the success rate of clearing residual thyroid was 54%.The success rates of first clearance of residual thyroid in patients with ^(131)I doses of 80 mCi,90 mCi,and 100 mCi were 37.50%(12/32),52.78%(19/36),and 71.88%(23/32),respectively,with statistically significant differences among the groups(P<0.05);The success rates of first removal of residual thyroid in patients with follicular carcinoma,mixed papillary follicular carcinoma,and papillary carcinoma were 65.71%(23/35),39.13%(9/23),and 52.38%(22/42),respectively.There was no statistically significant difference between the groups(P>0.05);The success rates of first removal of residual thyroid in the group1 of patients(treatment time<3 months),the group2 of patients(treatment time 3-12 months),and the group3 of patients(treatment time>12 months)were 68.09%(32/47),44.44%(16/36),and 35.30%(6/17),respectively.There was no statistically significant difference between the groups(P>0.05);There was no statistically significant difference in the success rate of clearing residual thyroid in DTC patients of different genders,ages,pathological stages,and thyroid stimulating hormone(TSH)levels(all P>0.05);The difference in the success rate of clearing residual thyroid in DTC patien

关 键 词：甲状腺肿瘤 碘放射性同位素 代谢清除率 

分 类 号：R736.1[医药卫生—肿瘤]