^(131)I治疗前ps-Tg水平对儿童及青少年分化型甲状腺癌疗效与预后的影响  

作　　者：叶挺[1] 郑阿莲 靳水 易贺庆[1] 

机构地区：[1]浙江省肿瘤医院,310022 [2]杭州市临平区第一人民医院星桥分院,311103

出　　处：《浙江临床医学》2024年第7期1022-1023,1026,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022KY676)。

摘　　要：目的探讨^(131)I治疗前刺激性甲状腺球蛋白(ps-Tg)水平对儿童及青少年分化型甲状腺癌(DTC)疗效与预后的影响。方法收集2011年1月至2022年8月86例儿童及青少年DTC患者的临床资料。按^(131)I治疗前ps-Tg水平,分为高ps-Tg组和正常组,比较两组临床资料、^(131)I治疗剂量,分析血清Tg水平变化,评价疗效。结果两组患儿在^(131)I治疗前ps-Tg值与M分期比较差异有统计学意义(P<0.05);高ps-Tg组在治疗后1年Tg水平高于正常组。正常组结构性疗效不佳(SIR)率为21.8%,高ps-Tg组为77.4%,随访期间正常组新发转移10例,治疗前ps-Tg水平为34.87 ng/mL,高ps-Tg组新发转移3例,ps-Tg水平为304.5 ng/mL。结论^(131)I治疗前ps-Tg水平及其动态变化可以作为预测儿童及青少年DTC复发、转移的有效指标。Objective To investigate the impact of high ps-Tg levels before ^(131)I treatment on the efficacy and prognosis of Differentiated thyroid carcinoma(DTC)treatment in children and adolescents.Methods Eighty-six pediatric and adolescent DTC patients admitted to our hospital from January 2011 to August 2022 were retrospectively collected.According to the pre ^(131)I treatment ps-Tg levels,the patients were divided into a high ps-Tg group and a normal group.The clinical data and ^(131)I treatment dose of DTC in children and adolescents were compared between the two groups.The trend of changes in serum Tg levels before and after ^(131)I treatment was analyzed,and the efficacy response was evaluated.Results The difference between the ps-Tg value and M stage before ^(131)I treatment was statistically significant(P<0.05)between the two groups of children,the Tg level of the high ps-Tg group was still higher than that of the normal group although it was lower at 1 year after treatment.The rate of structural ineffectiveness(SIR)was 21.8%in the normal group and 77.4%in the high ps-Tg group.10 new metastases were found in the normal group during the follow-up period,with a pre-treatment ps-Tg level of 34.87 ng/mL,and 3 new metastases were found in the high ps-Tg group,with a ps-Tg level of 304.5 ng/mL.Conclusion The high ps-Tg levels and their dynamic changes before ^(131)I treatment can serve as effective indicators for predicting the recurrence and metastasis of DTC in children and adolescents.

关 键 词：刺激性甲状腺球蛋白 儿童 青少年 碘放射性同位素 分化型甲状腺癌 疗效 预后转归 

分 类 号：R736.1[医药卫生—肿瘤]