分化型甲状腺癌肺转移灶放射性碘治疗临床疗效评估  

Evaluation of radioiodine therapy in patients with lung metastases from differentiated thyroid carcinoma

作　　者：崔静[1] 高永举[1] 武新宇[1] 

机构地区：[1]河南省人民医院核医学科,河南郑州450003

出　　处：《肿瘤影像学》2016年第4期-,共4页Oncoradiology

基　　金：河南省科技攻关项目(No:162102310015)

摘　　要：目的:通过监测放射性^(131)I显像、甲状腺球蛋白(thyroglobulin,Tg)值及胸部CT评估分化型甲状腺癌(differentiated thyroid carcinoma,DTC)肺转移患者^(131)I治疗疗效。方法:回顾分析在河南省人民医院核医学科行^(131)I治疗的42例DTC肺转移患者,通过动态监测^(131)I显像、Tg值和胸部CT等评价^(131)I治疗肺转移灶的疗效。结果:42例患者中,5例临床治愈,20例好转,有效率59.5%(25/42);17例无效或病情进展,无效率40.5%(17/42)。单纯按^(131)I显像、胸部CT、Tg值判断,治疗有效率分别为64.3%(27/42)、71.4%(30/42)和59.5%(25/42)。治疗前后Tg值比较有统计学差异(Z=-2.026,P=0.043)。结论:^(131)I能较为有效地治疗和控制DTC肺转移病灶。Tg值异常升高,经^(131)I治疗后无明显降低,提示^(131)I治疗疗效欠佳。^(131)I显像、Tg值、胸部CT动态监测是查找肺转移和评价^(131)I治疗疗效的重要指标。Objective:To investigate the value of131I imaging, thyroglobulin (Tg) value and chest CT in the assessment of131I therapy in patients with lung metastases from differentiated thyroid carcinoma (DTC).Methods:From June 2008 to June 2014, 42 patients with lung metastases from DTC were retrospectively analyzed.131I imaging, Tg value, and chest CT were carried out in the assessment of diagnosis and follow-up.Results:59.5% (25/42) cases achieved a response by131I therapy, while 40.5%(17/42) cases had no effective response. The effective rates of treatment assessed by single131I imaging, chest CT and Tg value were 64.3% (27/42), 71.4% (30/42) and 59.5% (25/42). There was signiifcant difference in Tg value before and after131I therapy (Z=-2.026,P=0.043).Conclusion:131I therapy is effective in treatment and control DTC lung metastases in most patients. An obviously increased Tg value demonstrates a poor prognosis.131I imaging, chest CT and Tg value are important procedures in the assessment of 131I therapy in patients with lung metastases from DTC.

关 键 词：分化型甲状腺癌 肺转移 131I 甲状腺球蛋白 计算机断层扫描 

分 类 号：R445.5[医药卫生—影像医学与核医学]