摘要
目的探讨分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后首次^(131)I治疗清除残余甲状腺组织的疗效及相关影响因素。方法回顾性分析行^(131)I治疗的309例DTC患者临床资料,对可能影响^(131)I治疗的相关因素采用单因素分析和logistic回归分析。结果 309例患者^(131)I治疗成功率为76.7%;单因素分析显示治疗前刺激状态下甲状腺球蛋白(stimulating thyroglobulin,sTg)水平、^(131)I治疗剂量及转移情况是^(131)I治疗的影响因素(χ~2=21.833,P<0.001;χ~2=7.960,P=0.019;χ~2=186.801,P<0.001);二元logistic回归分析显示,首次治疗前sTg水平及术后淋巴结转移和远处转移是影响术后^(131)I疗效的独立影响因素(OR=0.965,P<0.001;OR=0.008,P<0.001;OR=0.011,P<0.001);治疗前sTg预测治疗未成功的AUC为0.678,最佳截断值为6.775μg/L,灵敏度为45.1%,特异度为81.3%,阴性预测值为87.8%。结论首次^(131)I治疗DTC患者术后残存甲状腺组织的疗效确切;治疗前sTg水平、^(131)I治疗剂量及转移情况是疗效的影响因素;sTg水平及转移情况是预测^(131)I疗效的重要指标。
Objective To investigate the effect of initial 131I therapy after operation on removing the residual thyroid tissue in patients with differentiated thyroid carcinoma（DTC）and its influencing factors.Methods The clinical data of309 DTC patients undergoing 131I therapy were retrospectively analyzed.Univariate analysis and logistic regression analysis were adopted to evaluate the influencing factors for the therapeutic effect.Results The success rate of initial 131I therapy was 76.7%（237/309）.Univariate analysis factors of 131I therapy showed that the stimulating thyroglobulin（sTg）level,initial 131I therapy and metastases were the influential factors for the initial 131I therapy result（χ2=21.833,P〈0.001;χ2=7.960,P=0.019;χ2=186.801,P〈0.001）.Logistic regression analysis showed that the sTg level before initial 131I therapy as well as lymph node and distant metastases after operation were the independent influencing factors for the 131I therapy result（OR=0.965,P=0.001;OR=0.008,P〈0.001;OR=0.011,P〈0.001）.When the cut-offvalue of sTg was 6.775μg/L,the AUCfor predicting unsuccess of 131I therapy was 0.678,the sensitivity was45.1%,the specificity was 81.3%,and the negative predictive value was 87.8%.Conclusion The initial 131I therapy is effective for the removal of residual thyroid tissue in DTC patients.The sTg level,initial 131I therapy dose and metastases are the influencing factors for 131I therapy,and the sTg level and metastases are the important indexes for predicting the therapeutic effect.
作者
张莹
段莉莉
高永举
ZHANG Ying;DUAN Li-li;GAO Yong-ju(Department of Nuclear Medicine, Henan Provincial People＇s Hospital, People＇s Hospital of Zhengzhou University, Zhengzhou 450003, Chin)
出处
《中华实用诊断与治疗杂志》
2018年第6期567-570,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家临床重点专科医学影像项目[豫财社(2013)226号]
关键词
分化型甲状腺癌
131I
残余甲状腺组织
影响因素
Differentiated thyroid carcinoma
131I
residual thyroid tissue
influencing factors
