Hfu Hongliang, Ma Chao, Li Jianing, Feng Fang, Wu Shuqi, Ye Zhiyi, Wang Hui
Department of Nuclear Medicine, Xin Hua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China -
Q J Nucl Med Mol Imaging. 2016 Sep;60(3):280-4. Epub 2014 Sep 5.
The aim of this study was to evaluate the efficacy of radioiodine remnant ablation (RRA) for differentiated thyroid carcinoma (DTC) patients with an incomplete thyroidectomy.
The medical histories of postsurgical DTC patients who accepted RRA between 2010 and 2012 were retrospectively reviewed. Among them, 113 patients who had undergone a total or near-total thyroidectomy comprised the complete thyroidectomy group (CT group) and the remaining 40 patients who had undergone a lobectomy or sub-total thyroidectomy comprised the incomplete thyroidectomy group (ICT group). The difference in the patients' age, gender, histology, serum TSH level and 24hr radioactive iodine uptake (RIU) between the two groups was analyzed by χ2 Test or ANOVA. The efficacy of RRA in ICT group was evaluated by comparing its rate of complete ablation after the first RRA and its cumulative rate of complete ablation after the second RRA to the rate of complete ablation after the first RRA in CT group respectively by χ2 Test.
Of all the clinical characteristics, only serum TSH level and 24hr RIU have significant difference between two groups (P<0.01 for both). The rate of complete ablation after the first RRA was 67.26% in CT group. The rate of complete ablation after the first RRA and the cumulative rate of complete ablation after the second RRA was 27.50% and 67.50% respectively in ICT group. The ablative rate of the first RRA between the two groups was compared by χ2 Test and the difference was significant (P<0.01). The ablative rate of the first RRA in CT group was compared with the cumulative rate of the second RRA in ICT group and the difference was not significant (P=0.978).
Although the efficacy of RRA in DTC patients with an incomplete thyroidectomy is not as good as that of patients with a complete thyroidectomy after the first RRA, a higher ablative rate can still be achieved after the second or third RRA.
本研究旨在评估放射性碘残留消融（RRA）对甲状腺次全切除术后分化型甲状腺癌（DTC）患者的疗效。
回顾性分析2010年至2012年间接受RRA的DTC术后患者的病史。其中，113例行甲状腺全切除或近全切除的患者组成甲状腺全切除组（CT组），其余40例行甲状腺叶切除或次全切除的患者组成甲状腺次全切除组（ICT组）。采用χ2检验或方差分析比较两组患者的年龄、性别、组织学、血清促甲状腺激素（TSH）水平和24小时放射性碘摄取率（RIU）。通过χ2检验分别比较ICT组首次RRA后的完全消融率及其第二次RRA后的累积完全消融率与CT组首次RRA后的完全消融率，以评估ICT组中RRA的疗效。
在所有临床特征中，两组间仅血清TSH水平和24小时RIU有显著差异（均P<0.01）。CT组首次RRA后的完全消融率为67.26%。ICT组首次RRA后的完全消融率和第二次RRA后的累积完全消融率分别为27.50%和67.50%。采用χ2检验比较两组首次RRA的消融率，差异有统计学意义（P<0.01）。比较CT组首次RRA的消融率与ICT组第二次RRA的累积消融率，差异无统计学意义（P=0.978）。
虽然RRA对甲状腺次全切除术后DTC患者的疗效在首次RRA后不如甲状腺全切除术后患者，但在第二次或第三次RRA后仍可获得较高的消融率。
